Impact of the Diabetes Shared Care Program on Glycemic Control in Older Adults With Type 2 Diabetes

Abstract

Background: This study aimed to assess the impact of the Diabetes Shared Care Program (DSCP) on glycemic control among elderly patients with type 2 diabetes mellitus (T2DM) over 1 year and identify factors associated with A1C level outcomes.

Methods: A retrospective cohort study was conducted at a regional hospital in central Taiwan from 2016 to 2020. The study included 509 patients aged ≥ 65 years with a confirmed T2DM diagnosis who participated in the program for at least 1 year. A1C levels were analyzed using three thresholds (6.5%, 7%, and 8%), and sociodemographic and health-related factors were examined. Statistical analyses included paired t-tests, the McNemar test, and binary logistic regression models.

Results: After 1 year in the DSCP, the mean A1C level significantly decreased from 7.37 ± 1.30 to 7.11 ± 1.13 (P < 0.001). Glycemic control patterns varied across A1C thresholds, with the most significant improvements observed at the 8% threshold, while improvements were less pronounced at the 6.5% threshold. Abnormal waist circumference was significantly associated with poorer glycemic control, with odds ratios of 2.570 (95% confidence interval (CI): 1.409 - 4.690, P = 0.002) for A1C < 6.5%, 2.360 (95% CI: 1.362 - 4.087, P = 0.002) for A1C < 7%, and 3.169 (95% CI: 1.909 - 5.261, P < 0.001) for A1C < 8%.

Conclusions: The DSCP significantly improved glycemic control in elderly patients with T2DM. Targeted diabetes education interventions should be implemented for older adults at higher risk, particularly those with abnormal waist circumference.