The prevalence of diabetes mellitus and quality of diabetic care in residential and nursing homes. A postal survey

OBJECTIVE: to investigate the prevalence of known diabetes mellitus in care homes and the patterns of diabetes care in these institutions. DESIGN: a postal questionnaire sent to all 98 care homes in Sheffield. RESULTS: 70 care homes (71%) returned the questionnaire, indicating that 233 (8.8%) of 2648 residents were known to have diabetes. Of these, 76 (33%) were treated with diet alone, 105 (45%) with diet plus oral medication and 52 (22%) with insulin. Only seven registered nurses (2%) in the homes had certified diabetes training. Forty-two homes (60%) did not carry out a structured, diabetes-related assessment of residents on entry and only 29 (42%) had regular review of diabetic residents by a general practitioner or practice nurse. Most homes (89%) were visited by an optician, 56 (80%) also had a regular chiropody service, although 32 (46%) of these charged their residents for this service. CONCLUSIONS: the known prevalence of diabetes is similar to that reported previously. This study highlights the need for structured care with defined standards for care-home residents with diabetes.