Diabetes self-management programmes in older adults: a systematic review and meta-analysis
D Sherifali1,2,3, J-W Bai1, M Kenny3
1Faculty of Health Sciences, McMaster University.
Summary
Diabetes self-management programs show modest improvements in older adults' HbA1c, lipids, and blood pressure. Tailored or psychologically focused programs were most effective for glycemic control.
Area of Science:
- Gerontology
- Endocrinology
- Public Health
Background:
- Evidence for diabetes self-management programs in older adults is inconsistent.
- Variations exist in methodological approaches and disease criteria.
- A systematic evaluation is needed to clarify program effectiveness.
Purpose of the Study:
- To evaluate the effect of diabetes-specific self-management program interventions in older adults.
- To apply predetermined methodological criteria for study selection.
- To synthesize evidence on program efficacy in this population.
Main Methods:
- Searched EMBASE, MEDLINE, and Cochrane Central Register from 1980-2013.
- Included reference lists from systematic reviews, meta-analyses, and guidelines.
- Analyzed 13 trials involving 4517 older adults (2361 intervention, 2156 control).
Main Results:
- Pooled effect showed a reduction in HbA1c of -2 mmol/mol (-0.2%).
- Tailored or psychologically focused programs yielded greater HbA1c reductions.
- Significant reduction in total cholesterol and non-significant reductions in blood pressure were observed.
Conclusions:
- Diabetes self-management programs offer a small but significant benefit for older adults.
- Improvements noted in HbA1c, lipids, and blood pressure.
- Programs may be more clinically relevant when integrated with other treatments.
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