Managing Diabetes in Older Adults: Current Approaches in Long-Term Care Facilities

This narrative review aims to explore the literature on advancements in diabetes management within long-term care facilities (LTCFs). Managing chronic diseases like diabetes in LTCFs is particularly challenging due to the dynamic nature of these environments and the significant changes they have undergone over the past decade. Various factors, including rising care costs and government regulations, influence the quality-of-care residents receive in these settings.

Many diabetes medications have not been extensively studied in LTCFs, and high-risk medications such as sulfonylureas and sliding scale insulin are still in use, potentially increasing the risk of morbidity and mortality among residents. Additionally, the adoption of diabetes technologies, such as continuous glucose monitors (CGMs) and insulin pumps, remains limited in LTCFs. Despite the high prevalence of diabetes, significant research gaps persist. Diabetes technologies have the potential to greatly improve diabetes management and outcomes for residents. However, more research is needed to evaluate their efficacy and safety in long-term care settings. Furthermore, there is a pressing need to address the gap in staff training on the use of these technologies. Closing these research gaps is essential for developing evidence-based guidelines and improving the quality of diabetes care in LTCFs.