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Diabetes self-management programmes in older adults: a systematic review and meta-analysis.
- Source :
- Diabetic Medicine; Nov2015, Vol. 32 Issue 11, p1404-1414, 11p, 5 Charts
- Publication Year :
- 2015
-
Abstract
- Aim The evidence for self-management programmes in older adults varies in methodological approaches, and disease criteria. Using predetermined methodological criteria, we evaluated the effect of diabetes-specific self-management programme interventions in older adults. Methods The EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials databases were searched from January 1980 to November 2013, as were reference lists from systematic reviews, meta-analyses and clinical practice guidelines. A total of 13 trials met the selection criteria, which included 4517 older adult participants; 2361 participants randomized to a diabetes self-management programme and 2156 to usual care. Results The pooled effect on HbA<subscript>1c</subscript> was a reduction of -2 mmol/mol (-0.2%; 95% CI -0.3 to -0.1); tailored interventions [-3 mmol/mol (-0.2%; 95% CI -0.4 to -0.1)] or programmes with a psychological emphasis [-3 mmol/mol (-0.2; 95% CI -0.4 to -0.1)] were most effective. A pooled treatment effect on total cholesterol was a 5.81 mg/dl reduction (95% CI -10.33 to -1.29) and non-significant reductions in systolic and diastolic blood pressure. Conclusions Diabetes self-management programmes for older adults demonstrate a small reduction in HbA<subscript>1c</subscript>, lipids and blood pressure. These findings may be of greater clinical relevance when offered in conjunction with other therapies. [ABSTRACT FROM AUTHOR]
- Subjects :
- TYPE 2 diabetes treatment
PSYCHOLOGICAL adaptation
BLOOD pressure
BLOOD pressure measurement
CONFIDENCE intervals
DATABASES
GLYCOSYLATED hemoglobin
HEALTH services accessibility
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
LIPIDS
MEDICAL care
MEDICAL protocols
MEDICAL practice
MEDLINE
META-analysis
TYPE 2 diabetes
PATIENT education
PATIENTS
QUALITY assurance
HEALTH self-care
SUPPORT groups
DATA analysis
SOCIAL support
HUMAN services programs
INDIVIDUALIZED medicine
SYMPTOMS
Subjects
Details
- Language :
- English
- ISSN :
- 07423071
- Volume :
- 32
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Diabetic Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 110400455
- Full Text :
- https://doi.org/10.1111/dme.12780