{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:59:07Z","timestamp":1789595947562,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["IIR 15\u2010434"],"award-info":[{"award-number":["IIR 15\u2010434"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K01AG073532"],"award-info":[{"award-number":["K01AG073532"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K24AG066998"],"award-info":[{"award-number":["K24AG066998"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["T32\u2010AG000212"],"award-info":[{"award-number":["T32\u2010AG000212"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AG057751"],"award-info":[{"award-number":["R01AG057751"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Guidelines recommend nursing home (NH) residents with cognitive impairment receive less intensive glycemic treatment and less frequent fingerstick monitoring. Our objective was to determine whether current practice aligns with guideline recommendations by examining fingerstick frequency in Veterans Affairs (VA) NH residents with diabetes across cognitive impairment levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified VA NH residents with diabetes aged \u226565 residing in VA NHs for &gt;30\u2009days between 2016 and 2019. Residents were grouped by cognitive impairment status based on the Cognitive Function Scale: cognitively intact, mild impairment, moderate impairment, and severe impairment. We also categorized residents into mutually exclusive glucose\u2010lowering medication (GLM) categories: (1) no GLMs, (2) metformin only, (3) sulfonylureas\/other GLMs (+\/\u2212 metformin but no insulin), (4) long\u2010acting insulin (+\/\u2212 oral\/other GLMs but no short\u2010acting insulin), and (5) any short\u2010acting insulin. Our outcome was mean daily fingersticks on day 31 of NH admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 13,637 NH residents, mean age was 75\u2009years and mean hemoglobin A1c was 7.0%. The percentage of NH residents on short\u2010acting insulin varied by cognitive status from 22.7% in residents with severe cognitive impairment to 33.9% in residents who were cognitively intact. Mean daily fingersticks overall on day 31 was 1.50 (standard deviation\u00a0=\u00a01.73). There was a greater range in mean fingersticks across GLM categories compared to cognitive status. Fingersticks ranged widely across GLM categories from 0.39 per day (no GLMs) to 3.08 (short\u2010acting insulin), while fingersticks ranged slightly across levels of cognitive impairment from 1.11 (severe cognitive impairment) to 1.59 (cognitively intact).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NH residents receive frequent fingersticks regardless of level of cognitive impairment, suggesting that cognitive status is a minor consideration in monitoring decisions. Future studies should determine whether decreasing fingersticks in NH residents with moderate\/severe cognitive impairment can reduce burdens without compromising safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17962","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T05:49:37Z","timestamp":1659592177000},"page":"3176-3184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fingerstick glucose monitoring by cognitive impairment status in Veterans Affairs nursing home residents with diabetes"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1637-0255","authenticated-orcid":false,"given":"Brian","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"Geriatrics, Palliative and Extended Care Service Line San Francisco Veterans Affairs Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7947-3008","authenticated-orcid":false,"given":"William James","family":"Deardorff","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"Geriatrics, Palliative and Extended Care Service Line San Francisco Veterans Affairs Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Shi","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"Geriatrics, Palliative and Extended Care Service Line San Francisco Veterans Affairs Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bocheng","family":"Jing","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"Geriatrics, Palliative and Extended Care Service Line San Francisco Veterans Affairs Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9525-3833","authenticated-orcid":false,"given":"Alexandra K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Geriatrics University of California, San Francisco  San Francisco California USA"},{"name":"Geriatrics, Palliative and Extended Care Service Line San Francisco Veterans Affairs Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sei J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Geriatrics 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2013.08.001"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2011.05.001"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2015.1035621"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15\u20102512"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21\u2010S012"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15\u2010S016"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2013.08.002"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.7345"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.7744"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.2275"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12547"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010016\u20100199\u20100"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16880"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17771"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.0022"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14\u20100599"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2011.03726.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102015\u2010009952"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.03.007"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000334"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.06.004"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/49.4.m174"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/54.11.M546"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.2288"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16395"}],"container-title":["Journal 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