Up-to-date Diabetic Management Guidelines for PAC/LTC Residents

Over the past several years, there have been many changes in diabetic management and treatment, such as the increasing use of continuous glucose monitors (CGM) and novel oral and injectable medications. The Post-Acute and Long-Term Care Medical Association (PALTmed, formerly AMDA) has released updated Clinical Practice Guidelines for Diabetic Management in Post-Acute Care and LTC.

Review the most updated guidelines highlighting key research-based findings and recommendations below:

1. Avoid prescribing restrictive diets for patients with diabetes unless this is a justified patient preference (usually with a goal of weight loss)

2. Avoid strict adherence to low A1C numbers

3. Avoid using sliding-scale insulin

4. Consider using oral agents in the classes DPP-4 inhibitors; SGLT2 inhibitors; and oral or injectable GLP1-RAs, each of which can improve diabetes management without increasing risk for hypoglycemia or other negative outcomes among older adults with diabetes. These agents are easily given by staff either orally or by weekly injections, without the need for regular BGM. Newer agents should be avoided in patients with contraindicated symptoms or conditions (e.g., GLP1-RAs in patients with motility issues or unintentional weight loss; SGLT2 inhibitors in patients who are bedbound and incontinent).

Read more about Diabetes Management HERE!