Health Systems & Behavioural Sciences, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore city, Singapore.
Centre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd, Singapore city, Singapore.
Sci Diabetes Self Manag Care. 2022 Dec;48(6):505-521. doi: 10.1177/26350106221125695. Epub 2022 Sep 24.
The purpose of the study was to investigate the effectiveness of a community-based intervention on improving knowledge about diabetes, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus (T2DM) in Singapore, a country in Asia with a high prevalence of diabetes.
A 3-arm cluster randomized controlled trial involving community-dwelling older adults ages 55 to 99 with T2DM was conducted. Intervention group 1 and 2 participants received a 12-session intervention program designed to teach knowledge and practical skills in diabetes self-care with psychological techniques for behavioral change like problem solving, goal setting, and motivational interviewing. In addition, intervention group 2 participants received a glucometer and a supply of accessories each. The control group received routine care from their health care providers.
Compared to the control group, intervention group 2 reported an increase in medication adherence and self-monitoring of blood glucose (SMBG) at 3-month follow-up and increased knowledge about diabetes and self-care behavior in general diet control at 6-month follow-up.
The community-based intervention should be extended to more older adults with T2DM in the community. Glucometers and accessories could be provided at subsidized rates or be made free contingent on older adults' income status to overcome the barrier of performing SMBG.
本研究旨在探讨社区为基础的干预措施对改善新加坡老年 2 型糖尿病（T2DM）患者的糖尿病知识、自我护理行为和血糖控制的有效性。新加坡是亚洲一个糖尿病高发国家。
采用三臂群随机对照试验，纳入年龄在 55 至 99 岁、居住在社区的 T2DM 老年患者。干预组 1 和 2 参与者接受了为期 12 节的干预计划，旨在教授糖尿病自我护理的知识和实用技能，并运用解决问题、设定目标和动机访谈等心理技巧来改变行为。此外，干预组 2 参与者还获得了血糖仪和一套配件。对照组接受其医疗保健提供者的常规护理。
与对照组相比，干预组 2 在 3 个月随访时报告药物依从性和自我监测血糖（SMBG）增加，在 6 个月随访时报告糖尿病知识和一般饮食控制自我护理行为增加。
应将社区为基础的干预措施推广到更多的社区老年 T2DM 患者。血糖仪和配件可以以补贴的价格提供，或者根据老年人的收入状况免费提供，以克服执行 SMBG 的障碍。
