Chairman and Chief of Strategy, Insight Therapeutics, LLC, Norfolk, VA.
Hackensack University Medical Center, Hackensack, NJ.
J Am Med Dir Assoc. 2024 Nov;25(11):105342. doi: 10.1016/j.jamda.2024.105342. Epub 2024 Oct 11.
The newly revised Clinical Practice Guideline (CPG) for Diabetes Management in the Post-Acute and Long-Term Care (PALTC) Setting is an extremely useful resource that incorporates new evidence and perspectives related to overall goals in diabetes care. The CPG provides detailed information in usable Tables for how to use and manage the increasing number of medication alternatives for PALTC patients with diabetes. In addition, the CPG addresses the critical roles of all members of the interprofessional team for the optimal management of older adults living with diabetes. The primary goal of care as described in the CPG is to make diabetes management individualized and consistent with the patient's/resident's goals of care, and to optimize quality of life and the ability to live in the least restrictive setting possible. To achieve this, the CPG emphasizes the importance of understanding the patients' overall health status, what their preferences and values are, their life expectancy, the clinical benefit of tight versus more liberal control of glucose, risk of hypoglycemia, and impact of treatment on quality of life and ability to live in a certain setting of care (e.g., if injectable therapy is possible). As with other PALTmed CPGs, this new CPG takes the team through the process of recognition, assessment, treatment and monitoring. Implementation of the Diabetes Management in PALTC Settings CPG can help those working in these settings ensure that their patients and residents are getting the most appropriate and current evidence-based treatment for this challenging clinical problem.
新修订的《急性后期和长期护理环境中糖尿病管理临床实践指南》(CPG)是一个非常有用的资源,它纳入了与糖尿病护理总体目标相关的新证据和新观点。该 CPG 以实用表格的形式提供了有关如何为患有糖尿病的 PALTC 患者使用和管理不断增加的药物替代方案的详细信息。此外,该 CPG 还涉及到跨专业团队的所有成员在优化管理患有糖尿病的老年人方面的关键作用。CPG 中描述的护理主要目标是使糖尿病管理个体化,并与患者/居民的护理目标一致,并优化生活质量和在尽可能少限制的环境中生活的能力。为了实现这一目标,CPG 强调了了解患者整体健康状况、他们的偏好和价值观、预期寿命、严格控制血糖与更宽松控制血糖的临床获益、低血糖风险以及治疗对生活质量和在特定护理环境中生活能力的影响(例如,是否可以进行注射治疗)的重要性。与其他 PALTmed CPG 一样,该新 CPG 引导团队完成识别、评估、治疗和监测的过程。实施《急性后期和长期护理环境中的糖尿病管理临床实践指南》可以帮助在这些环境中工作的人员确保他们的患者和居民获得最适合和最新的基于证据的治疗方法,以应对这一具有挑战性的临床问题。