Diabetes self‐management programmes in older adults: a systematic review and meta‐analysis. Issue 11 (29th April 2015)

• Record Type: Journal Article
• Authors: Sherifali, D.; Bai, J.‐W.; Kenny, M.; Warren, R.; Ali, M. U.
• Is Part Of: Diabetic medicine. Volume 32:Issue 11(2015:Nov.)
• Page Start: 1404
• Page End: 1414
• Publication Date: 2015-04-29
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12780
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12780-abs-0001"> <title>Abstract</title> <sec id="dme12780-sec-0001" sec-type="section"> <title>Aim</title> <p>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.</p> </sec> <sec id="dme12780-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="dme12780-sec-0003" sec-type="section"> <title>Results</title> <p>The pooled effect on HbA<sub>1c</sub> 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.</p> </sec> <sec id="dme12780-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Diabetes self‐management programmes for older adults demonstrate a small reduction in HbA<sub>1c</sub>, lipids and blood pressure. These findings may be of greater clinical relevance when offered in conjunction with other therapies.</p> </sec> </abstract>