Guidelines for Diabetes Care in Long Term Care
of BQA 00-048 (PDF, 11 KB)
Date: July 3, 2000 DSL-BQA-00-048
To: Nursing Homes NH 26 Attention: Directors of Nursing
From: La Vern Woodford, Chief, Resident Care Review Section
Pat Zapp, Director, Wisconsin Diabetes Control Program
via: Susan Schroeder, Director, Bureau of Quality Assurance
Diabetes is a common, costly, but controllable disease in Wisconsin. It is estimated
that approximately 330,000 people have diabetes in Wisconsin, 158,360 of whom are over the
age of 65. Complications of diabetes include blindness, nerve damage and kidney disease.
In 1994, the Wisconsin Department of Health and Family Services established the
Wisconsin Diabetes Control Program. The goal of the program is to improve care for
individuals with diabetes in Wisconsin. The Diabetes Control Program established the
Wisconsin Diabetes Advisory Group, a group now made up of more than 50 statewide
organizations working to improve care for individuals with diabetes. (A list of the
Advisory Group organizations is attached.) The Advisory Group worked together to develop
the Wisconsin Essential Diabetes Mellitus Care Guidelines. These guidelines have
been widely distributed in Wisconsin. A copy of the Guidelines can be downloaded from the
We wanted to provide guidelines for the care and management of residents
with diabetes in long term care settings. We found the enclosed guidelines to be practical
and sensitive. The guidelines were developed by Minneapolis/St. Paul Diabetes Educators,
Minnesota Long-term Care Organizations, Gerontology Practitioners and the Minnesota
Diabetes Control Program. These guidelines were updated at the end of 1999 and incorporate
information from recent research and standards of care.
The goals of the guidelines include:
To prevent crises or suffering related to inadequate control of diabetes mellitus in the
long term care setting.
To prevent and treat complications of diabetes mellitus in order to preserve function
and maintain an optimal quality of life.
There is a great deal of patient variability in the long-term care setting. Facilities
now care for elderly residents, as well as younger residents, admitted for short-term
sub-acute care. Many residents are also quite frail. They often suffer from multiple
chronic illnesses that worsen with age. This often makes treatment decisions very
complicated and requires careful balancing of choices.
When specific treatments are suggested, it is crucial to determine if aggressive
treatment is appropriate. Specific treatments may not be indicated if the resident is
terminally ill, has an end-stage condition, or when the treatment would not change the
residents outcome. The wishes of the resident and his/her family should play a major
role in the decision-making process.
We would like to know your thoughts about the guidelines. Please complete the enclosed
form [not available on the Internet] and return it in the self-addressed envelope. If the
Diabetes Control Program staff can be of assistance to you, please do not hesitate to call
Pat Zapp, Director, Diabetes Control Program at (608) 261-6871. You can also e-mail Pat
Zapp at firstname.lastname@example.org.
Together, we can make a difference in the lives of the individuals in Wisconsin with
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