Self-management programs can improve health outcomes in older adults with diabetes

Sherifali D, Bai JW, Kenny M, et al. Diabetes self-management programmes in older adults: A systematic review and meta-analysis Diabetic Medicine. 2015 April.

Review question

Are self-management programs for diabetic older adults effective at improving their clinical outcomes (i.e. blood sugar, lipid content and blood pressure)?

Background

Due to the rising prevalence of diabetes in older adults, more elderly people face difficulty in managing their disease due to unique needs, functional disabilities and requirements for external support.

Self-management programs are diverse and can be delivered in a number of different ways.

It is currently unknown which programs of self-management support are associated with significant improvements in clinical outcomes amongst diabetic older adults.

How the review was done

A detailed search of a number of electronic databases for studies published between January 2004 and November 2013 was conducted. Studies that focused on older adults with diabetes and the effects of self-management support strategies to improve clinical outcomes were included in the review.

A total of 3,786 studies were identified in searches, and 13 were included in the review after assessments for eligibility.

The authors did not acknowledge any funding sources for this review.

What the researchers found

A limited number of high-quality studies support diabetes self-management programs that take into consideration the characteristics of individual needs and psychological well-being.

A small but significant reduction in blood sugar levels may be achieved with diabetes self-management programs, and a further reduction is observed when programs are offered in conjunction with diabetes therapies (e.g. pharmacology therapy).

The authors advise large scaled-up self-management programs may be advantageous for older adults when offered in conjunction with other diabetes therapies.

Conclusion

Older adults with diabetes who are supported with self-management programs that include individualized care and a focus on psychological well-being can improve their clinical outcomes. These programs may be even more successful when offered in conjunction with other therapies.