The University of Texas at Austin, School of Nursing, Austin, Texas (Ms Garcia, Dr Brown)
Diabetes Educ. 2011 Mar-Apr;37(2):167-87. doi: 10.1177/0145721710395330.
Diabetes mellitus is a disease with debilitating potential. Growing numbers of elderly individuals are being admitted to under-resourced nursing homes with this often complicated, time-intensive, and costly diagnosis. The purpose of this systematic review of the literature was to determine the trends in diabetes management in nursing homes over the last decade including the use of clinical practice guidelines and the evaluation of management outcomes.
Ten medical, nursing, psychological, legal, and business databases were searched for articles written in English between 2000 and 2010 addressing diabetes management in nursing homes or long-term care settings. They were analyzed to determine diabetes management characteristics, use of clinical practice guidelines, resident outcomes associated with different regimens, and implications for improved management and outcomes.
A total of 20 studies from 6 countries, primarily the United States, including both qualitative and quantitative designs and a combined sample of 779,707 residents, met the inclusion criteria. The majority of the studies described frequencies of various management practices and found rare clinical practice guideline adherence.
A severe lack of research relating management practices to health and quality-of-life outcomes was evident as was a lack of the voice of the resident in determining the diabetes regimen. Clear implications were found for improvement in diabetes management education for residents, families, and all health care providers in this setting.
糖尿病是一种具有致残潜力的疾病。越来越多的老年人被送往资源匮乏的养老院，而他们往往被诊断出这种复杂、耗时且昂贵的疾病。本次对文献的系统回顾旨在确定过去十年中养老院中糖尿病管理的趋势，包括临床实践指南的使用以及管理结果的评估。
检索了 2000 年至 2010 年间用英文撰写的、针对养老院或长期护理机构中糖尿病管理的医学、护理、心理、法律和商业数据库中的 10 篇文章。对这些文章进行分析，以确定糖尿病管理的特点、临床实践指南的使用、不同治疗方案与居民结果之间的关系，以及改善管理和结果的意义。
共有来自 6 个国家（主要是美国）的 20 项研究符合纳入标准，这些研究采用了定性和定量设计，样本总数为 779707 名居民。大多数研究描述了各种管理实践的频率，并发现临床实践指南的遵循率很低。
明显缺乏将管理实践与健康和生活质量结果联系起来的研究，也缺乏在确定糖尿病治疗方案时居民的意见。对于改善这一环境中居民、家属和所有医疗保健提供者的糖尿病管理教育，明显存在改进的意义。
