Provision of counseling on diabetes self-management: Are there any age disparities?

Objective: To determine whether there are any age-related disparities in the frequency of provision of counseling and education for diabetes care in a large HMO in Central Texas. Methods: EMR search from 13 primary care clinics on patients aged >= 18 years (n = 1300) who had been diagnosed with type 2 diabetes. Results: There were no significant age differences in the frequency of provision of counseling about HBGM, diet, smoking or diabetes education. However, there were significant age differences in the provision of exercise counseling. Patients aged >= 75 were significantly less likely to have been provided exercise counseling than those aged <65 (adjusted OR = 0.60; 95% CI = 0.37-0.98). The mean HbA1c for patients aged >= 75 and 65-74 were significantly lower than that of patients aged <65 (8.9 vs. 9.0 vs. 9.7; P<0.001). Conclusion: While age-related variations in self-management protocols were not found, the provision of formal diabetes education was low (29.4%). The persistence of key risk factors in later life (e.g., obesity) underscores the need for better self-management protocols for older adults. Practice Implications: Additional efforts on strategies to increase counseling about lifestyle habits and diabetes self-management care by appropriate health care providers is needed. Diabetes counseling should be individually tailored in older population. (C) 2010 Elsevier Ireland Ltd. All rights reserved.