ATTD 2025 - Managing Type 1 Diabetes in Long-term Care Facilities

At the Advanced Technologies and Treatments for Diabetes conference (ATTD) in Amsterdam this March, a presentation by Nashira Pandia, Professor of Geriatrics at Nova Southeastern University, Florida, focused on managing Type 1 diabetes in long-term care facilities, highlighted the need for improved guidelines, staff education, and advanced diabetes technology. Although the information was US-centric, it also applies to care facilities in the United Kingdom.

There is a significant lack of published data on Type 1 diabetes prevalence in US nursing homes, making it difficult to develop targeted interventions. The results from a small survey carried out by Nashira Pandia showed that many staff members lack an understanding of the differences between Type 1 and Type 2 diabetes, and many facilities do not have written diabetes policies in place.

Challenges in managing Type 1 diabetes, such as the misclassification of diabetes types, staff unfamiliarity with advanced technology, the lack of knowledge of hypoglycaemia / DKA, its recognition & treatment, can lead to inadequate, unsafe care.

In the United Kingdom, the National Advisory Panel for Care Home Diabetes (NAPCHD), chaired by Professor Alan Sinclair, recently developed a National Strategic Document of Diabetes Care for Care Homes, which highlighted this fragmentation of care, the lack of interdisciplinary collaboration & slow utilisation of diabetes technology.

The presentation emphasised the importance of interdisciplinary collaboration and standardised training programs. The speaker proposed using the 4M framework (Mentation, Medications, Mobility, and What Matters Most), an Age-Friendly Health System used in the United States. The goal is to ensure every older adult receives the best care possible, is not harmed by care & is satisfied with the care they receive. When put into practice, this framework is a success.

In conclusion, there is a pressing need for better data, adequate staff education, and policies to manage Type 1 diabetes effectively. Suggested actions include developing targeted training programmes, establishing & implementing standardised policies such as the NAPCHD document, and conducting further research into Type 1 diabetes prevalence and intervention effectiveness in nursing homes.

My Disclosure Statement:

"I am part of the #dedoc° voices program, an initiative of #dedoc°.

#dedoc° has granted me complimentary registration to the conference.

Part of being one of the #dedoc° voices is to #PayItForward, which means to share what I learn with my diabetes community. All words are my own."