Proactive health intervention outcomes in older adults with diabetes patients: a scoping review

The phenomenon of global population ageing is driving a marked increase in the prevalence of diabetes mellitus among the older population, who face multiple health burdens requiring comprehensive management. Current models are limited by an inadequate focus on cultivating patients' self-management capacities. Therefore, the establishment of a scientifically rigorous, holistic, proactive health management system covering the full disease cycle that encompasses the entire range of care for the designated population is essential. This study employs a scoping review methodology in order to systematically map and synthesize domestic and international evidence on proactive health interventions for older patients suffering from diabetes. The objective of this study is to elucidate the various intervention types, the core outcome measures, and the overall effect trends. The objective of this study is to comprehensively map the extant evidence and identify pivotal components, with the aim of informing the future development and implementation of proactive health management models for this group.

This study adheres to the Arksey and O'Malley framework for scoping reviews. Systematic searches were conducted across both Chinese and English databases, including CNKI, WanFang, CQVIP, CBM, PubMed, the Cochrane Library, and Web of Science. The search covered publications from January 2015 to October 2025. Two independent researchers screened and extracted the data.

The search yielded 813 publications, of which 24 studies were included in the final analysis: 10 in English and 14 in Chinese. The included studies consisted primarily of 15 randomized controlled trials, 2 qualitative studies, 4 quasi-experimental studies, along with 2 cohort studies and 1 pilot study. Proactive health interventions are now analyzed through a dual framework of core components: educational empowerment, and behavioral support. The core outcome measures focused on physiological indicators, such as glycated hemoglobin and fasting blood glucose; patient-reported outcomes, such as quality of life and self-management capacity; and other health-related indicators, such as nutritional status and oral health. The literature includes research findings that indicate a positive trend across all measurement domains.

To optimize care for older adults with diabetes, implementation of adaptable proactive health management strategies is crucial. Evidence indicates that patient-centered models emphasizing active participation improve key outcomes like glycemic control, quality of life, and self-management. Their success depends on adaptability to resource levels and individual characteristics, supported by multidisciplinary teams delivering personalized, evidence-based plans. Further clinical translation requires expanded evidence from large-scale randomized controlled trials assessing long-term efficacy and applicability to older subgroups with comorbidities, alongside standardization of core elements under national or professional guidance to enhance system efficiency and patient outcomes.