Zimmer J G, Williams T F
J Am Geriatr Soc. 1978 Oct;26(10):443-52. doi: 10.1111/j.1532-5415.1978.tb03322.x.
A descriptive and quality assessment study was made of 359 elderly patients with a diagnosis of diabetes mellitus in 39 Skilled Nursing Facilities (SNF) in upstate New York. The diagnostic prevalence of diabetes was about 12 percent--similar to that in a National Health Survey of nursing homes, but higher than that reported for the non-institutional elderly. Greater frequency and severity were observed among the females, but the median age for all the diabetic patients was about the same as that for the general SNF population. Several of the other disorders believed to be associated with diabetes were found to be of greater frequency in the SNF diabetic group, but some were not; also, inadequate control of diabetes was associated with some, but not all of these disorders. The severity of diabetes in this elderly SNF population with adult-onset diabetes was usually mild, with a low frequency of complications and of poor control. Problems arose with respect to the ascertainment and recording of diagnostic and control data, most often related to the responsibilities of the attending physicians. There were also problems of uncertainty as to the cause-and-effect relationship between thecontrol of blood glucose levels and treatment outcomes. The establishment of criteria and standards for medical care evaluation studies is discussed.
对纽约州北部39家专业护理机构（SNF）中359名诊断为糖尿病的老年患者进行了一项描述性和质量评估研究。糖尿病的诊断患病率约为12%，与全国养老院健康调查中的患病率相似，但高于非机构化老年人的报告患病率。女性中观察到更高的发病率和严重程度，但所有糖尿病患者的中位年龄与SNF总体人群的中位年龄大致相同。在SNF糖尿病组中，发现几种其他被认为与糖尿病相关的疾病发病率更高，但有些并非如此；此外，糖尿病控制不佳与其中一些疾病有关，但并非所有这些疾病。在这群患有成人发病型糖尿病的老年SNF人群中，糖尿病的严重程度通常较轻，并发症发生率低，控制不佳的情况也较少。在诊断和控制数据的确定和记录方面出现了问题，最常见的问题与主治医生的职责有关。关于血糖水平控制与治疗结果之间的因果关系也存在不确定性问题。讨论了医疗护理评估研究标准和规范的制定。
