Self-management of Diabetes for Empty Nest Older Adults: A Randomized Controlled Trial

Abstract

Background: Despite much evidence showing the effectiveness of structured self-management education for diabetes, poor glycemic control remains a challenge among empty nest older adults. Objective: We explored the effect of a health education intervention based on the PRECEDE-PROCEED model on the self-management of empty nest older adults with type 2 diabetes in Lanzhou, China. Methods: We conducted a 2-armed, randomized controlled trial using a multistage sampling method. A total of 100 patients were randomly assigned to receive either community nurse–led diabetes education based on the PRECEDE-PROCEED model or general community diabetes education. Self-management scores and blood glucose were compared at baseline and at 3 and 6 months after the intervention. Results: Analyses were conducted on the 98 patients completing follow-up. In the experimental group, diabetes self-management knowledge ( t = 7.578, P < .001), self-management attitude ( t = 9.155, P < .001), self-management behavior ( t = 7.809, P < .001), and overall self-management scores ( t = 7.626, P < .001) improved, with hemoglobin A1c ( t = −2.825, P = .006), fasting plasma glucose ( t = −3.100, P = .003), 2-hour postprandial blood glucose ( t = −3.812, P < .001), and diastolic blood pressure ( t = −2.104, P = .038) decreasing compared with the control group at 6 months postintervention. Conclusions: This study demonstrated that education based on the PRECEDE-PROCEED model was more effective than general health education in improving diabetes self-management and glycemic control among empty nest older adults.

Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition)

“…These methods can be carried out simultaneously to complement each other, to better pass on the necessary information to patients. In recent years, there have been numerous studies exploring different educational approaches for older patients with diabetes, such as the spousal‐assisted management model and the PRECEDE‐PROCEED model 25,26 . Effective educational approaches will contribute to the comprehensive management of older patients with diabetes.…”

“…In recent years, there have been numerous studies exploring different educational approaches for older patients with diabetes, such as the spousal‐assisted management model and the PRECEDE‐PROCEED model. 25 , 26 Effective educational approaches will contribute to the comprehensive management of older patients with diabetes. With the rapid development of artificial intelligence technology, recent years, there have also been several studies investigating the role of artificial intelligence in diabetes education.…”