Aim: To outline in what extent elderly people over 80 with Diabetes mellitus (DM) are monitored according to Swedish National guidelines, comparing those living at home with or without home health care and residents of nursing homes

Methods: Cross-sectional, medical record review elderly aged 80 and older with known DM, using quality indicators to evaluate diabetes care during a two-year period. Results: Adherence to HbA1c monitoring independent of medication was poor in nursing homes, 72%, (p<0.001). The HbA1c level <52mmol/mol (6.9% NGSP) was obtained for 34% of those living at home with and without home health care, 26% by residents in nursing homes. Insulin therapy was used to a greater extent in nursing homes (54%). Metformin was frequently used in the age group, 80-84, even at reduced e-GFR. Hypertension and coronary heart disease was the most common comorbidities in all groups. The prevalence of DM in the age group 80-89 was 18 %.

Conclusions: Poor adherence was seen in Hba1c, p-lipid, BP monitoring and performed foot examinations, among residents in nursing homes. There are major opportunities for improvement regarding the care of elderly with diabetes in generally and especially residents in Nursing homes, suggesting that co-ordination between primary health care and municipality provided care need to create methods for better cooperation.