Management of Diabetes in Nursing Homes: Nurses’ Perceptions on Diet and Meal Schedules

Abstract

Introduction: Diabetes affects more than 25% of elderly residents in nursing homes in Cádiz, Spain. Historically, therapeutic diets in these centers have included restrictions on calories, fats, and sugars, which may reduce food intake and increase the risk of malnutrition. In recent years, more flexible dietary approaches have emerged, aiming to improve both nutritional status and quality of life. Objective: To explore the perceptions and experiences of nurses in nursing homes regarding dietary management and meal schedules for residents with diabetes. Methods: A qualitative study was conducted with in-depth interviews of 18 nurses from nursing homes in Cádiz. Data were analyzed thematically. Results: Three major positions emerged: (1) Support for dietary flexibility, reported by 8 out of 18 nurses, who emphasized the positive effects of relaxed dietary restrictions on residents’ quality of life and emotional well-being. (2) Preference for strict diabetic diets, supported by 4 nurses, highlighting the importance of sugar-free and low-carbohydrate alternatives for glycemic control. (3) Criticism of current institutional meal schedules, expressed by 6 nurses, which were seen as rigid, contributing to long fasting periods and increased risk of nocturnal hypoglycemia. Nurses also noted that these schedules prioritize staff convenience over resident-centered care. Conclusions: Dietary management and institutional meal schedules pose significant challenges to diabetes care in nursing homes. Incorporating greater dietary flexibility and adapting meal schedules to residents’ individual needs may enhance both glycemic control and overall well-being.