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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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Effective Interventions for Homebound Older Adults With Type 2 Diabetes: A Systematic Review.

Sandra Iregbu1, Aprill Z Dawson2,3, Rebekah J Walker4

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Current Diabetes Reports
|April 5, 2025
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Homebound older adults with type 2 diabetes (T2DM) need targeted interventions. Home-based care, telehealth, and education show promise for improving clinical outcomes in this vulnerable population.

Keywords:
HomeboundOlder adultsSystematic reviewType 2 diabetes

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Area of Science:

  • Gerontology
  • Endocrinology
  • Public Health

Background:

  • Homebound older adults with type 2 diabetes (T2DM) experience poorer health outcomes than their non-homebound peers.
  • Identifying effective interventions for this specific demographic is crucial for improving care and outcomes.

Purpose of the Study:

  • To systematically review and summarize evidence on interventions designed to enhance outcomes for homebound older adults with T2DM.
  • To identify gaps in research and promising intervention strategies for this population.

Main Methods:

  • A systematic literature search was conducted across PubMed, CINAHL, SCOPUS, and PsycINFO databases until November 6, 2023.
  • Included studies were clinical trials focusing on participants aged 60+, examining various interventions and outcomes like HbA1c, blood pressure, QOL, and healthcare utilization.

Main Results:

  • Nine studies met the inclusion criteria, with most conducted in the US. Interventions included telehealth, home-based primary care, nutrition counseling, and meal delivery.
  • A significant lack of studies specifically tailored to homebound older adults with T2DM was identified.
  • Promising results were observed for interventions such as home-based primary care, case management, joint patient/caregiver education, and integrated home telemonitoring.

Conclusions:

  • Interventions delivered in the home setting, including integrated care models and technology, show potential for improving clinical outcomes in homebound older adults with T2DM.
  • Further research is needed to develop and evaluate interventions specifically designed for the unique needs of this population.