Skilled nursing providers should use caution when giving acetaminophen to residents with diabetes, researchers advise.

That’s because the over-the-counter pain relievers may increase some older adults’ risk of suffering a stroke. French researchers studied a population of more than 5,400 nursing home residents, about 2,200 of which were taking acetaminophen.

They concluded that the drug is a safe first choice to manage pain for most older adults, but should be used carefully for seniors with diabetes, according to the analysis, first published March 26 in the Journal of the American Geriatrics Society.

“Pain can be treated simply, but we must ensure our therapeutic arsenal is safe,” concluded authors with the Centre Hospitalo–Universitaire de Toulouse, in Toulouse, France. “Pain management in nursing homes remains a health priority that is still insufficiently addressed.”