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A Community‐based Study of Diabetes‐related Skills and Knowledge in Elderly People with Insulin‐requiring Diabetes
Author(s) -
Pegg A.,
Fitzgerald F.,
Wise D.,
Singh B.M.,
Wise P.H.
Publication year - 1991
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1991.tb01700.x
Subject(s) - medicine , diabetes mellitus , insulin , population , hypoglycemia , disease , peripheral neuropathy , pediatrics , endocrinology , environmental health
An open cross‐sectional study of elderly (age > 65 yr) patients with insulin‐requiring diabetes mellitus (n = 57) was undertaken to audit safety of self‐management. Levels of knowledge and management skills of hypoglycaemia, hyperglycaemia, and foot care were determined. The prevalence of hypoglycaemia, visual impairment, and at‐risk feet and the ability to perform practical procedures (insulin injection and self‐monitoring) were assessed. Drawing up insulin and self‐injection was correct in 84% and 76% of patients, but 53% of self‐monitored urine or blood tests were performed incorrectly. Twenty‐six per cent experienced hypoglycaemia at least monthly and 25% had been seen at the hospital with hypoglycaemia in the last year. Eighteen per cent did not know what action to take with hypoglycaemia. Forty‐six per cent did not know any hyperglycaemic symptoms or signs. Prompted with symptoms, 35% still did not know what to do and 21% would take inappropriate action when self‐monitored tests read high. Fifty‐one per cent had impaired vision, 61% peripheral neuropathy and 24% peripheral vascular disease, with the result that 78% had at‐risk feet. Fifteen percent inspected or washed their feet infrequently, 40% walked barefoot occasionally, and 47% would take potentially dangerous action in the event of foot injury. This study demonstrates serious deficiencies in the basic education and management skills in our elderly insulin‐requiring diabetic population that could result in morbidity and mortality. Greater effort and vigilance by health care professionals must be directed towards this group.