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Ajjan RA, Battelino T, Cos X, Del Prato S, Philips JC, Meyer L, Seufert J, Seidu S. Continuous glucose monitoring for the routine care of type 2 diabetes mellitus. Nat Rev Endocrinol 2024; 20:426-440. [PMID: 38589493 DOI: 10.1038/s41574-024-00973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/10/2024]
Abstract
Although continuous glucose monitoring (CGM) devices are now considered the standard of care for people with type 1 diabetes mellitus, the uptake among people with type 2 diabetes mellitus (T2DM) has been slower and is focused on those receiving intensive insulin therapy. However, increasing evidence now supports the inclusion of CGM in the routine care of people with T2DM who are on basal insulin-only regimens or are managed with other medications. Expanding CGM to these groups could minimize hypoglycaemia while allowing efficient adaptation and escalation of therapies. Increasing evidence from randomized controlled trials and observational studies indicates that CGM is of clinical value in people with T2DM on non-intensive treatment regimens. If further studies confirm this finding, CGM could soon become a part of routine care for T2DM. In this Perspective we explore the potential benefits of widening the application of CGM in T2DM, along with the challenges that must be overcome for the evidence-based benefits of this technology to be delivered for all people with T2DM.
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Affiliation(s)
- Ramzi A Ajjan
- The LIGHT Laboratories, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Tadej Battelino
- Faculty of Medicine, University of Ljubljana Medical Centre, Ljubljana, Slovenia
| | - Xavier Cos
- DAP Cat Research Group, Foundation University Institute for Primary Health Care Research Jordi Gol i Gorina, Barcelona, Spain
| | - Stefano Del Prato
- Section of Diabetes and Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Laurent Meyer
- Department of Endocrinology, Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Medicine II, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Samuel Seidu
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
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2
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Johansson UB, Andreassen Gleissman S, Korkeila Liden M, Wickman M, Gustafsson B, Sjöberg S. Mixed methods study on the feasibility of implementing periodic continuous glucose monitoring among individuals with type 2 diabetes mellitus in a primary care setting. Heliyon 2024; 10:e29498. [PMID: 38660249 PMCID: PMC11041009 DOI: 10.1016/j.heliyon.2024.e29498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
Background Health care professionals (HCPs) play a central role in leveraging technologies to support individuals with diabetes. This mixed-method study was completed to determine the feasibility of implementing periodic continuous glucose monitoring (CGM) in a primary care setting. Aim This study aimed to evaluate and describe the experiences of using periodic CGM with data visualization tools in patients with type 2 diabetes to foster a person-centered approach in a primary care setting. Methods Fifty outpatients aged ≥18 years, diagnosed with type 2 diabetes, and with a disease duration of at least 2 years were included in this study. Data were collected from April 2021 to January 2022. Patients completed a single period of sensor measurements for 28 days and a diabetes questionnaire about feelings and experiences of health care. HbA1c was also measured. A focus group interview was conducted to evaluate and describe the HCPs experiences of using periodic CGM. Results Patients reported to HCPs that the CGM device was comfortable to wear and noted that LibreView was easy to use when scanning the sensor to obtain and visualize the glucose levels and trends. Data availability of CGM data was >70 %.Clinical observations revealed a mean reduction in HbA1c, mmol/mol from 60.06 [7.65 %] at baseline to 55.42 [7.20 %] after 4 weeks (p < 0.001). Two categories were identified: 1) Fostering dialogue on self-care and 2) Promoting understanding. Conclusions The HCPs and participants in this study had a positive experience or viewed the implementation of periodic CGM with data visualization tools as a positive experience and appeared to be feasible for implementation in a primary care setting.
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Affiliation(s)
- Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, P.O. Box 5605, SE-114, 86, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, P.O. Box, 5605, SE-114 86, Stockholm, Sweden
| | | | | | - Marie Wickman
- Department of Health Promoting Science, Sophiahemmet University, P.O. Box 5605, SE-114, 86, Stockholm, Sweden
| | - Berit Gustafsson
- Insurance Clinic, Sophiahemmet, P.O. Box 5605, SE-114 86, Stockholm, Sweden
| | - Stefan Sjöberg
- Department of Health Promoting Science, Sophiahemmet University, P.O. Box 5605, SE-114, 86, Stockholm, Sweden
- Insurance Clinic, Sophiahemmet, P.O. Box 5605, SE-114 86, Stockholm, Sweden
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Krall JS, Ng JM, Mehrotra N, Ruppert K, Siminerio LM. Insights into the Feasibility and Acceptability of a Mobile Insulin Titration Application in Clinical Practice and Its Effects on Diabetes Outcomes. TOUCHREVIEWS IN ENDOCRINOLOGY 2024; 20:52-57. [PMID: 38812671 PMCID: PMC11132646 DOI: 10.17925/ee.2024.20.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/02/2023] [Indexed: 05/31/2024]
Abstract
Introduction: Insulin therapy is most effective if patients learn how to properly adjust insulin to achieve glycaemic targets. There is a need for methods and tools that can assist these processes in clinical practice. The purpose of this feasibility study was to evaluate an approach to support insulin dose adjustment in individual patients using a mobile titration application (app). Methods: A cohort of adults (N=36) with type 2 diabetes with suboptimal glycaemia who were starting basal insulin self-titration were trained by a diabetes care and education specialist to use a mobile titration app to guide adjusting insulin doses. Glycaemia, diabetes distress and patient and provider satisfaction were assessed during the first 3 months after initiating basal insulin titration using the mobile app. Results: Mean haemoglobin type A1c (HbA1c) was significantly reduced by an average of 2.1 ± 2.2% from baseline to 3 months (p<0.001). Diabetes distress significantly decreased from baseline to follow-up with scores going down (or improving) across all scales. Both patients and providers reported high levels of satisfaction and positive experiences. Conclusion: The model offers a promising solution to streamline insulin dosage adjustments to achieve specific clinical and self-management goals with high expectations for long-term benefits and warrants further investigation.
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Affiliation(s)
- Jodi S Krall
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jason M Ng
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- niversity of Pittsburgh, Department of Medicine, Division of Endocrinology and Metabolism, Pittsburgh, PA, USA
| | - Neha Mehrotra
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- niversity of Pittsburgh, Department of Medicine, Division of Endocrinology and Metabolism, Pittsburgh, PA, USA
| | - Kristine Ruppert
- University of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA, USA
| | - Linda M Siminerio
- niversity of Pittsburgh, Department of Medicine, Division of Endocrinology and Metabolism, Pittsburgh, PA, USA
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Meyrowitsch DW, Thi Dang NA, Phong TV, Nielsen J, Søndergaard J, Cuong ND, Le Minh H, Vu TKD, Bygbjerg IC, Gammeltoft TM, Thanh ND. The effects of diabetes clubs on peer-support, disclosure of diabetes status, and sources of information regarding diabetes management: results of a pilot-intervention in rural Vietnam. Public Health 2024; 228:171-177. [PMID: 38364677 DOI: 10.1016/j.puhe.2023.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To measure the effects of diabetes clubs on peer support, disclosure of diabetes status, and the source of information regarding the management of diabetes among persons living with type-2 diabetes (T2D) in rural Vietnam. STUDY DESIGN A pre- and post-pilot intervention study was carried out in Thai Binh Province, Vietnam (n = 222). RESULTS Post-intervention, 57.7 % reported using experiences shared by other persons with T2D during the diabetes club sessions. Compared to pre-intervention, there was an increase in the proportion of persons with T2D who disclosed their diabetes status to friends and/or community members (an increase of 15.3 and 13.8 percentage points, respectively). The proportion of persons who reported gathering their own information regarding diabetes management without any support from others decreased from 15.7 % to 6.3 %. Those who reported a relative inside their home or a relative outside their household as their primary source of T2D-relevant information increased from 10.8 % to 18.6 % and from 2.7 % to 9.5 %, respectively. Persons who mentioned that they did not have a need for further support for their diabetes care increased from 18.5 % to 32.0 %. Specific support regarding diabetes-related knowledge received from family members, friends, and/or community members increased from 27.5 % to 62.2 % CONCLUSIONS: These findings suggest a promising potential for the implementation of diabetes clubs to enhance diabetes-relevant knowledge and the quality of self-management among persons living with T2D diabetes in rural areas of Vietnam.
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Affiliation(s)
- D W Meyrowitsch
- Global Health Section, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark.
| | - N-A Thi Dang
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - T V Phong
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - J Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark
| | - J Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Denmark
| | - N D Cuong
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - H Le Minh
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - T K D Vu
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
| | - I C Bygbjerg
- Global Health Section, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1353, Copenhagen K, Denmark
| | - T M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353 Copenhagen K, Denmark
| | - N D Thanh
- Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Thai Binh City, Thai Binh Province, Viet Nam
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Luo H, Cummings DM, Xu L, Watson A, Payton C. Diabetes Self-management Education and Support Completion Before and During the COVID-19 Pandemic: Results From Local Health Departments in North Carolina. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:686-690. [PMID: 37071075 DOI: 10.1097/phh.0000000000001749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE To assess diabetes self-management education and support (DSMES) completion rate and explore the differences in DSMES completion by different delivery models. METHODS We conducted a retrospective analysis of 2017-2021 DSMES data at 2 local health departments (LHDs) in Eastern North Carolina. We evaluated DSMES completion by 2 delivery models. RESULTS From 2017 to 2021, the overall DSMES completion rate was 15.3%. The delivery model of two 4-hour sessions was associated with a higher completion rate than the delivery model of four 2-hour sessions ( P < .05). Patients with less than a high school education and without health insurance were less likely to have completed their DSMES training ( P < .05). CONCLUSION The DSMES completion rate at LHDs in North Carolina is very low. A delivery model consisting of 10 hours of education delivered in fewer sessions may contribute to a higher DSMES completion rate, but more research is needed. Targeted programs are needed to engage patients and improve DSMES completion.
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Affiliation(s)
- Huabin Luo
- Department of Public Health, Brody School of Medicine (Drs Luo and Cummings), and Department of Health Education & Promotion, College of Health and Human Performance (Dr Xu), East Carolina University, Greenville, North Carolina; Diabetes Program, Pitt County Health Department, Greenville, North Carolina (Ms Watson); and Community and Clinical Connections for Prevention and Health Branch, Chronic Disease and Injury Section, NC Division of Public Health, Raleigh, North Carolina (Ms Payton)
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Yu S, Wan R, Bai L, Zhao B, Jiang Q, Jiang J, Li Y. Transformation of chronic disease management: Before and after the COVID-19 outbreak. Front Public Health 2023; 11:1074364. [PMID: 37064686 PMCID: PMC10090362 DOI: 10.3389/fpubh.2023.1074364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Adults with chronic diseases often experience a decline in their quality of life along with frequent exacerbations. These diseases can cause anxiety and impose a significant economic burden. Self-management is a crucial aspect of treatment outside of the hospital and can improve quality of life and reduce the financial burden resulting from unexpected hospitalizations. With the COVID-19 pandemic, telehealth has become a vital tool for both medical professionals and patients; many in-person appointments have been canceled due to the pandemic, leading to increased reliance on online resources. This article aimed to discuss various methods of chronic disease management, both traditional self-management and modern telehealth strategies, comparing before and after the COVID-19 outbreak and highlighting challenges that have emerged.
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Affiliation(s)
- Steven Yu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Rongjun Wan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Lu Bai
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Bingrong Zhao
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Qiaoling Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Juan Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- Juan Jiang,
| | - Yuanyuan Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Yuanyuan Li,
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Williams A, Shrodes JC, Radabaugh JN, Braun A, Kline D, Zhao S, Brock G, Nolan TS, Garner JA, Spees CK, Joseph JJ. Outcomes of Cooking Matters for Diabetes: A 6-week Randomized, Controlled Cooking and Diabetes Self-Management Education Intervention. J Acad Nutr Diet 2023; 123:477-491. [PMID: 35961614 PMCID: PMC10862535 DOI: 10.1016/j.jand.2022.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/08/2022] [Accepted: 07/24/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Diabetes self-management education and support is the cornerstone of diabetes care, yet only 1 in 2 adults with diabetes attain hemoglobin A1c (HbA1c) targets. Food insecurity makes diabetes management and HbA1c control more difficult. OBJECTIVE Our aim was to test whether a cooking intervention with food provision and diabetes self-management education and support improves HbA1c and diabetes management. DESIGN This was a waitlist-controlled, randomized trial. PARTICIPANTS/SETTING Participants were 48 adults with type 1 or type 2 diabetes. INTERVENTION Cooking Matters for Diabetes was adapted from Cooking Matters and the American Diabetes Association diabetes self-management education and support intervention into a 6-week program with weekly food provision (4 servings). MAIN OUTCOME MEASURES Surveys (ie, Summary of Diabetes Self-Care Activities; Medical Outcomes Study Short Form Health Survey, version 1; Diet History Questionnaire III; 10-item US Adult Food Security Survey Module; and Stanford Diabetes Self-Efficacy Scale) were administered and HbA1c was measured at baseline, post intervention, and 3-month follow-up. STATISTICAL ANALYSIS Mixed-effects linear regression models controlling for sex and study wave were used. RESULTS Mean (SD) age of participants was 57 (12) years; 65% identified as female, 52% identified as White, 40% identified as Black, and 19 (40%) were food insecure at baseline. Intervention participants improved Summary of Diabetes Self-Care Activities general diet score (0 to 7 scale) immediately post intervention (+1.51; P = .015) and 3 months post intervention (+1.23; P = .05), and improved Medical Outcomes Study Short Form Health Survey, version 1, mental component score (+6.7 points; P = .025) compared with controls. Healthy Eating Index 2015 total vegetable component score improved at 3 months (+0.917; P = .023) compared with controls. At baseline, food insecure participants had lower self-efficacy (5.6 vs 6.9 Stanford Diabetes Self-Efficacy Scale; P = .002) and higher HbA1c (+0.77; P = .025), and demonstrated greater improvements in both post intervention (+1.2 vs +0.4 Stanford Diabetes Self-Efficacy Scale score; P = .002, and -0.12 vs +0.39 HbA1c; P = .25) compared with food secure participants. CONCLUSIONS Cooking Matters for Diabetes may be an effective method of improving diet-related self-care and health-related quality of life, especially among food insecure patients, and should be tested in larger randomized controlled trials.
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Affiliation(s)
- Amaris Williams
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jennifer C Shrodes
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jessica N Radabaugh
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio
| | - Ashlea Braun
- Department of Nutritional Sciences, School of Education and Human Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Songzhu Zhao
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Guy Brock
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Timiya S Nolan
- The Ohio State University College of Nursing, Columbus, Ohio
| | - Jennifer A Garner
- The School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio; The John Glenn College of Public Affairs, The Ohio State University, Columbus, Ohio
| | - Colleen K Spees
- Division of Medical Dietetics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Joshua J Joseph
- The Ohio State University College of Medicine, Columbus, Ohio.
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Izquierdo V, Pazos-Couselo M, González-Rodríguez M, Rodríguez-González R. Educational programs in type 2 diabetes designed for community-dwelling older adults: A systematic review. Geriatr Nurs 2022; 46:157-165. [PMID: 35700683 DOI: 10.1016/j.gerinurse.2022.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/14/2022]
Abstract
AIMS This systematic review aimed to assess the effectiveness of educational interventions in type 2 diabetes specifically designed for community-dwelling older adults. METHODS In accordance with PRISMA guidelines, a systematic search of studies published between 2010 and 2021 was conducted across five electronic databases and manual sources. The study protocol was previously registered in PROSPERO (CRD42021288236). RESULTS Twelve papers matched the inclusion criteria and were appraised using MERSQI. The features of the educational programs were heterogeneous, and none complied with the ten suggested standards for diabetes self-management education and support. Comprehensive gerontological assessment was not considered. Outcomes included biomedical, psychosocial, behavioral, and knowledge measures. HbA1c and knowledge showed improvements with a high certainty level according to GRADE. CONCLUSIONS Structured DSME programs aimed at older adults have great potential, however there is still room to improve. Applying the principles of a comprehensive gerontological approach and the standards for DSME as continuous monitoring and support could increase their benefits.
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Affiliation(s)
- Veronica Izquierdo
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Marcos Pazos-Couselo
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Research Methods (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | | | - Raquel Rodríguez-González
- Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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9
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Bravo JJM. [Importance of adherence to healthy lifestyles in people with diabetes]. Semergen 2021; 47:141-143. [PMID: 33975690 DOI: 10.1016/j.semerg.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
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