Annals of Long Term Care

Tighter glycemic control does not necessarily protect residents in long-term care facilities (LTCF) from acquiring pneumonia, reported Chen and colleagues in a recent study published in the Journal of the American Medical Directors Association (http://www.ncbi.nlm.nih.gov/pubmed/21194657). In a 2-year prospective cohort study involving 233 residents from a total of 10 private LTCFs in Taiwan, Chen and colleagues set out to determine the relationships among diabetes mellitus, glycemic control, and LTCF-acquired pneumonia. Of the residents (average age,76.9 ± 10.6 years), 27.9% were diabetic. There were 173 episodes of LTCF-acquired pneumonia. The researchers found that the incidence of these episodes between patients with and without diabetes, or between diabetic patients with different status of glycemic control were similar. After adjusting for baselin Barthel index, Charlson comorbidity index, and baseline serum albumin levels, diabetes mellitus was not considered a significant risk factor for LTCF-acquired pneumonia. Poor glycemic control (HbA1c >7%) was also not a significant risk factor for LTCF-acquired pneumonia in diabetic subjects. Chen and colleagues concluded, "A prospective randomized controlled trial is needed to determine the optimal goal of glycemic control for LTCF residents."