Diabetes as a Home Health Care Concern

The U.K. Prospective Diabetes Study (UKPDS)8 and the Diabetes Control and Complications Trial (DCCT)9 have shown that optimal control of blood glucose can make a difference in preventing diabetes-related complications. The question now is how health care providers can understand and use the UKPDS and DCCT to enhance diabetes management and health status. Rappaport et al.10 expressed the hope that these studies might encourage patients and providers to take glycemic control seriously “by creating plans to aggressively treat hyperglycemia and other risk factors and recognizing that at any point throughout the life span, patients can alter the appearance or progression of diabetes complications.”

Many home health care patients have never achieved glycemic control and are found on admission to home care to have blood glucose levels well over 200 mg/dl, a level considered toxic11 that impairs leukocyte function,12 resulting in predisposition to infection. If diabetes is not identified as a home care concern, blood glucose measurement may not even be included in initial or ongoing patient assessments. Again, most home health care patients in the United States are referred by hospitals to home health care for whatever comorbid condition led to their hospitalization; they are rarely referred for diabetes care itself.

Source : http://spectrum.diabetesjournals.org