JAMDA
Volume 12, Issue 1 , Pages 33-37, January 2011

Diabetes Mellitus, Glycemic Control, and Pneumonia in Long-Term Care Facilities: A 2-Year, Prospective Cohort Study

  • Liang-Kung Chen, MD

      Affiliations

    • Division of Geriatric Medicine, Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang Ming University School of Medicine, Taipei, Taiwan
    • ,
  • Li-Ning Peng, MD

      Affiliations

    • Division of Geriatric Medicine, Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang Ming University School of Medicine, Taipei, Taiwan
    • ,
  • Ming-Hsien Lin, MD

      Affiliations

    • Division of Geriatric Medicine, Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang Ming University School of Medicine, Taipei, Taiwan
    • ,
  • Hsiu-Yun Lai, MD

      Affiliations

    • Division of Geriatric Medicine, Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang Ming University School of Medicine, Taipei, Taiwan
    • ,
  • Hsin-Chieh Lin, RN

      Affiliations

    • National Taipei College of Nursing, Taipei, Taiwan
    • ,
  • Shinn-Jang Hwang, MD

      Affiliations

    • Division of Geriatric Medicine, Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
    • National Yang Ming University School of Medicine, Taipei, Taiwan
    • Corresponding Author InformationAddress correspondence to Shinn-Jang Hwang, MD, Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Shih-Pai Road Section 2, Taipei, Taiwan 11217.

published online 09 August 2010.

Objective

To determine the relationships among diabetes mellitus (DM), glycemic control, and long-term care facility (LTCF)–acquired pneumonia.

Design

Prospective cohort study.

Setting

Ten private LTCFs in Taiwan.

Participants

Participants were 233 LTCF residents.

Measurements

Barthel index (BI), Charlson comorbidity index (CCI), hemoglobin A1c, episodes of LTCF-acquired pneumonia.

Intervention

None.

Results

A total of 233 residents (76.9 ± 10.6 years, 54.9% males, 27.9% diabetic) from 10 private LTCFs participated. There were 173 LTCF-acquired pneumonia episodes. The incidence of LTCF-acquired pneumonia between patients with and without diabetes, or between diabetic subjects with different status of glycemic control was similar. Adjusted for baseline BI, CCI, feeding tube placement, and baseline serum albumin, DM was not a significant risk factor for LTCF-acquired pneumonia. Poorer glycemic control (HbA1c >7%) was not a significant risk factor for LTCF-acquired pneumonia in diabetic subjects.

Conclusions

Tighter glycemic control did not protect diabetic LTCF residents from pneumonia. A prospective randomized controlled trial is needed to determine the optimal goal of glycemic control for LTCF residents.

Keywords: Diabetes mellitus, elderly, long-term care, nursing home

 

 The authors have no conflicts of interest.

PII: S1525-8610(10)00036-8

doi:10.1016/j.jamda.2010.01.010

JAMDA
Volume 12, Issue 1 , Pages 33-37, January 2011

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