Evidence map›Paper›PMID 33064879›Full record

ArticleJournal of the American Geriatrics Society2021

Fingerstick Glucose Monitoring in Veterans Affairs Nursing Home Residents with Diabetes Mellitus.

Sun Y Jeon, Ying Shi, Alexandra K Lee, Lauren Hunt, Kasia Lipska, John Boscardin, Sei Lee

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Sliding Scale Insulin Use in Nursing Homes Before and After Onset of the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2024
    Article
  5. Ten-Year Prospective Follow-Up of Institutionalized Patients With Diabetes in a Long-Term Care Home.Clinical diabetes : a publication of the American Diabetes Association · 2023
    Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Sun Y JeonDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Ying ShiDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Alexandra K LeeDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Lauren HuntSan Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
Kasia LipskaDepartment of Internal Medicine, Section of Endocrinology, Yale School of Medicine, New Haven, Connecticut, USA.
John BoscardinDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Sei LeeDivision of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
University of California, San Francisco · USSan Francisco VA Medical Center · USYale University · US

Funding

Research Education ComponentP30AG062422 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Gil Dan Rabinovici · 2019 to 2026
$36.9M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
Developing prognostic models for life expectancy and geriatric outcomesR01AG047897 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI LEE, SEI, SMITH, ALEXANDER KELIIMOEANU · 2015 to 2018
$1.7M
Prognostic calculators for patients with Alzheimers disease and related dementiasR01AG057751 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI LEE, SEI, SMITH, ALEXANDER KELIIMOEANU · 2018 to 2021
$1.5M
Mentoring Patient-Oriented Research to Individualize Care for Hospitalized Older Adults with and without Alzheimer's Disease and Related DementiasK24AG066998 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Sei Lee · 2021 to 2026
$1.1M
Individualizing Treatment for Nursing Home Residents with Diabetes MellitusK23AG040779 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEE, SEI · 2011 to 2013
$526k
HSRD VA I01 HX002135HSRD VA IIR 15-434NIA NIH HHS K23 AG040779NIA NIH HHS K23AG040779NIA NIH HHS K24 AG066998NIA NIH HHS P30 AG062422NIA NIH HHS R01 AG047897NIA NIH HHS R01AG047897NIA NIH HHS R01 AG057751NIA NIH HHS R01AG057751NIA NIH HHS T32 AG000212
6 · The paper itself

Abstract

BACKGROUND/

objectiveGuidelines recommend less intensive glycemic treatment and less frequent glucose monitoring for nursing home (NH) residents. However, little is known about the frequency of fingerstick (FS) glucose monitoring in this population. Our objective was to examine the frequency of FS glucose monitoring in Veterans Affairs (VA) NH residents with diabetes mellitus, type II (T2DM). DESIGN AND

settingNational retrospective cohort study in 140 VA NHs.

participantsNH residents with T2DM and older than 65 years admitted to VA NHs between 2013 and 2015 following discharge from a VA hospital. MEASUREMENTS: NH residents were classified into five groups based on their highest hypoglycemia risk glucose-lowering medication (GLM) each day: no GLMs; metformin only; sulfonylureas; long-acting insulin; and any short-acting insulin. Our outcome was a daily count of FS measurements.

resultsAmong 17,474 VA NH residents, mean age was 76 (standard deviation (SD) = 8) years and mean hemoglobin A1c was 7.6% (SD = 1.5%). On day 1 after NH admission, 49% of NH residents were on short-acting insulin, decreasing slightly to 43% at day 90. Overall, NH residents had an average of 1.9 (95% confidence interval (CI) = 1.8-1.9) FS measurements on NH day 1, decreasing to 1.4 (95% CI = 1.3-1.4) by day 90. NH residents on short-acting insulin had the most frequent FS measurements, with 3.0 measurements (95% CI = 2.9-3.0) on day 1, decreasing to 2.6 measurements (95% CI = 2.5-2.7) by day 90. Less frequent FS measurements were seen for NH residents receiving long-acting insulin (2.1 (95% CI = 2.0-2.2) on day 1) and sulfonylureas (1.7 (95% CI = 1.5-1.8) on day 1). Even NH residents on metformin monotherapy had 1.1 (95% CI = 1.1-1.2) measurements on day 1, decreasing to 0.5 (95% CI = 0.4-0.6) measurements on day 90.

conclusionAlthough guidelines recommend less frequent glucose monitoring for NH residents, we found that many VA NH residents receive frequent FS monitoring. Given the uncertain benefits and potential for substantial patient burdens and harms, our results suggest decreasing FS monitoring may be warranted for many low hypoglycemia risk NH residents.

Indexed as

Diabetes Mellitus, Type 2Drug MonitoringHypoglycemic AgentsAgedBlood GlucoseFemaleGuideline AdherenceHomes for the AgedHumansHypoglycemiaMaleNursing HomesPractice Guidelines as TopicProcedures and Techniques UtilizationRisk AssessmentUnited StatesBlood GlucoseHypoglycemic Agentsdiabetes mellitus, type IIfingerstickglucose-lowering medicationglucose monitoringVeterans Affairs nursing home

Identifiers

PMID33064879
PMCPMC8139138
OpenAlexW3093160381

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.