Diabetes in care homes: a cluster randomised controlled trial of resident education

Introduction Residents of care homes with diabetes are a vulnerable group, lacking comprehensive assessment, monitoring, and specialist access. This study aimed to determine whether a short-term patient centred intervention strategy might benefit people with diabetes living in residential care homes. Methods Residents with diabetes were recruited and randomised (by care home) to intervention (25 homes: 57 residents) or control (26 homes: 45 residents). The intervention consisted of a medical review and individualised resident educational programme. The control group received usual care. Measures of glycaemic control (fasting glucose and HbA1c), quality of life, functional ability, cognition, mood, and diabetes knowledge were collected at baseline and after 6 months. Results After 6 months the intervention group, compared with control, had better quality of life, mood and diabetes knowledge and a slight increase in HbA1c from a mean value of 6.84 % (1.54) to 7.49 % (1.82). Reports of hypoglycaemia were less at the end of the study in both groups. Conclusions The intervention improved patient-centred outcomes, with a small effect on glycaemic control. More research needs to be performed with care home residents to develop the evidence base for appropriate interventions in this neglected group of patients.