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Do older adults aged 60 to 75 years benefit from diabetes behavioral interventions?
Beverly EA, Fitzgerald S, Sitnikov L, Ganda OP, Caballero AE, Weinger K
Diabetes Care 2013 Jun;36(6):1501-1506
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: In this secondary analysis, we examined whether older adults with diabetes (aged 60 to 75 years) could benefit from self-management interventions compared with younger adults. Seventy-one community-dwelling older adults and 151 younger adults were randomized to attend a structured behavioral group, an attention control group, or one-to-one education. RESEARCH DESIGN AND METHODS: We measured A1C, self-care (3-day pedometer readings, blood glucose checks, and frequency of self-care), and psychosocial factors (quality of life, diabetes distress, frustration with self-care, depression, self-efficacy, and coping styles) at baseline and 3, 6, and 12 months postintervention. RESULTS: Both older (age 67 +/- 5 years, A1C 8.7 +/- 0.8%, duration 20 +/- 12 years, 30% type 1 diabetes, 83% white, 41% female) and younger (age 47 +/- 9 years, A1C 9.2 +/- 1.2%, 18 +/- 12 years with diabetes, 59% type 1 diabetes, 82% white, 55% female) adults had improved A1C equally over time. Importantly, older and younger adults in the group conditions improved more and maintained improvements at 12 months (older structured behavioral group change in A1C -0.72 +/- 1.4%, older control group -0.65 +/- 0.9%, younger behavioral group -0.55 +/- 1.2%, younger control group -0.43 +/- 1.7%). Furthermore, frequency of self-care, glucose checks, depressive symptoms, quality of life, distress, frustration with self-care, self-efficacy, and emotional coping improved in older and younger participants at follow-up. CONCLUSIONS: The findings suggest that, compared with younger adults, older adults receive equal glycemic benefit from participating in self-management interventions. Moreover, older adults showed the greatest glycemic improvement in the two group conditions. Clinicians can safely recommend group diabetes interventions to community-dwelling older adults with poor glycemic control.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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