This paper summarizes evidence on effectiveness of diabetes self-care interventions for older adults with diabetes, and identifies factors influencing self-care behaviours. The search for articles published from 2002 to 2012 was done using electronic databases, namely, MEDLINE, CINAHL, Scopus, PsycINFO and PubMed. Search terms include diabetes, self-management, self-care, barriers and intervention. Out of 261 articles screened, 21 were selected for review. Findings revealed that interventions using concepts of self-efficacy, self-determination and proactive coping, and interventions incorporating information technology were effective in influencing diabetes self-care behaviours with improved health outcomes. Psychosocial factors influencing self-care include motivation, socioeconomic status, literacy, knowledge, social and health-care providers' support, and particularly for older adults, the key factors were their self-efficacy, motor skill and literacy in self-care activities. This review provides important insight for nurse practitioners to address psychosocial issues in developing self-care management programmes for older adults with diabetes.

Aim: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for people with poorly controlled type 2 diabetes in Singapore.Background: Over the past decades, Asia has emerged as the "diabetes epicentre"

This randomized controlled trial examined the effect of a diabetes self-efficacy enhancing program (DSEEP) on older adults with type 2 diabetes. The 8-week DSEEP consisted of a guidebook on diabetes self-care, a 1-day workshop, and fortnightly follow-up telephone calls. In total, 113 participants (56 in intervention group and 57 in control group) completed the study. Data were collected at baseline and at 8 weeks from the baseline. Outcome measures included self-efficacy, diabetes self-care activities, health-related quality of life, glycated hemoglobin (HbA1c) and unplanned health care service usage. Compared with participants in the control group, those who received DSEEP had significantly higher increase in self-efficacy and diabetes self-care activities, lower HbA1c, and lesser unplanned health service usage. However, there was no significant difference in health-related quality of life between the two groups. The DSEEP increased self-efficacy, which successfully enhanced self-care activities and reduced HbA1c.

Findings have important implications in Singapore as well as in other Asian countries where populations are also aging and diabetes prevalence is increasing. The findings provide new culturally focused insights for clinical patient education within the Southeast Asian context to improve diabetes self-care management of older adults.