| Summary: | People with type 2 diabetes, also known as non-insulin-dependent diabetes or adult onset diabetes, produce less insulin and are often overweight. The prevalence of type 2 diabetes increases with age as more people live longer. The prevalence of diabetes among Canadian seniors was 21.3% between 2006 and 2007. In the US, one in three residents of long-term care facilities have diabetes, of which 95% are type 2 diabetes. Older people with diabetes are at an increased risk for urinary tract infections, skin infections, foot ulcers, and pneumonia or flu. Treatment goals vary depending on the overall health of the residents. Usual goals for non-institutionalized adults include HbA1c <7.0%, before meal blood glucose levels 70-130 mg/dl, after meal (2 hours) blood glucose levels <180 mg/dl, blood pressure < 130/80 mmHg, and LDL cholesterol <100 mg/dl. Oral medications or injectable insulin are used to manage high blood sugar, while other agents may be used to control cardiovascular risk factors such as high blood pressure or cholesterol. However, good nutrition plays an important part of diabetes care, since undernutrition is common in frail older people, who often live in the long term care facilities and are dependent on the help of others to perform daily activities due to decreasing in strength, endurance and physiological function, the level of which can be characterized by using a clinical frailty scale. It is therefore important to know whether or not dietary restrictions such as "diabetic diets" should be used in such population. "Diabetic diets" are generally healthy diets that are individualized based on preferences, abilities and treatment goals using the advantages and disadvantages of dietary interventions listed in the chapter of Nutrition Therapy of the Canadian Diabetes Association Clinical Practice Guidelines. The aim of this report is to review the guidelines regarding nutritional management for frail elderly residents in long term care
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