This content reviews evidence-based nursing approaches to managing type 2 diabetes in elderly patients. It emphasises the role of evidence-based practice models in improving patient-centred care and health outcomes.
Contemporary nursing aims to present a review of the management of type 2 diabetes in elderly patients as they are vulnerable to developing complications and comorbidities. This assignment will hence seek to discuss various sound evidence guides towards the management of type 2 diabetes in older adults, particularly in nursing practice. Evidence-based practice is important in nursing as it integrates current evidence, the nurse’s expertise, and the patient values for the improvement of patient outcomes. EBP helps the nurse, as noted by Hu et al. (2024), to offer patient-centred care to garner improved disease management as well as the prevention of complications in elderly diabetic patients. Some EBP models such as the Iowa Model of Evidence-Based Practice define process frameworks for selecting clinical issues, evaluating evidence, and integrating competent evidence into practice.
To cope with type 2 diabetes in older people, the best practices include coordinating care and using personalized care planning, lifestyle changes, proper glycaemic monitoring according to age and mental health condition, as well as pharmacologic therapies. Therefore, different long-term care settings require specific diabetes management focusing on pathology changes with aging and decreased risk of hypoglycaemia as pointed out by the authors in this study, Idrees et al, 2025. These protocols effectively promote respect, safety, and individualism of the individual or patient based on professional nursing practice.
The NMC Code of Conduct supports the integration of EBP in nursing by encouraging safe, effective, and up-to-date practice about individual patients. By following the specific standards in the NMC Code, nurses can practice accountability and promote care that is not only one that is sensitive to the patient’s feelings and needs but is also based on evidence-based knowledge. With regards to our research question, this re-emphasizes the role of the nurse in implementing evidence to facilitate the elderly diabetes patients gain the best control to manage their condition to gain a better quality of life with little or no risks to healthcare.
5 Years | MSc
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Databases and Rationale
The two databases that were used in the literature search include PubMed and CINAHL databases. PubMed was chosen as the favoured database because of its vast coverage of both Medline and individual journals that contain peer-reviewed articles on the medical, nursing, and healthcare fields. CINAHL was selected for this review because it specializes in nursing and allied health sciences and as such helpful in identifying nursing-centred intervention and the quality of the evidence.
Keywords and Boolean Phrasing
As a first step in the search, appropriate MeSH terms that would allow for a sensitive approach to the entry were employed together with the words. The Boolean search string used was as follows:
”Type 2 diabetes mellitus” OR “T2DM”, “elderly”, “older adults”, “aged”, “nursing interventions”, “nursing care”, “nursing practice” “management” “treatment”, “primary research”, “clinical trial”.
The mentioned Boolean connectors “AND” and “OR” enabled the successful formation of logical categories of the related terms and increased the specificity and scope of the findings. This approach made it possible to select the articles that will address not only the issues of diabetes and nursing but those that have special attention to the elderly population as well.
Inclusion and Exclusion Criteria
To enhance the search results, certain inclusion and exclusion criteria were used to filter the extracts. The inclusion criteria of the review were as follows: (1) studies published between January 2020 and December 2025, (2) written in English, (3) they are focused on primary data like randomized controlled trials, cohort, or intervention studies, (4) the samples involve elderly individuals with Type 2 diabetes, and (5) the studies include nursing intervention. Therefore, articles were excluded if it was (1) a review, meta-analysis, or protocol, (2) where the subject matter covered pharmacological intervention without the involvement of the nursing roles, or (3) a non-refereed article.
The selection of 2020–2025 was made to include only the most recent and clinically up-to-date evidence regarding nursing care practices and standards. This restricted the inclusion of only research that was likely to be relevant to clinical care, showing the widely valuable findings.
Search Execution and Screening Process
Refined search terms and filters were applied to conduct searches in each database. An initial scanning of the articles was done using the title and the abstract to remove any irrelevant articles. Consequently, full-text screening was conducted for all the articles enlisted to adhere strictly obey to the inclusion/exclusion criteria. These are some of the sources which were used in the search process to manage and organize the search results as well as avoid the use of the repeat information; Reference management software (Zotero).
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From this process, five works were chosen as the most commensurate with the topic in concern which is nursing interventions for elderly persons with Type 2 diabetes. All these studies had different methodological approach; however, they provided FT direct evidence on the efficacy of interventions led or supported by the nurses in clinical or community context.
Rationale and Relevance
The method of structured searching makes for an added advantage since it enhances the transparency and replicability of the research process as well as enhances the rigor of the evidence-based research. The inclusion of Boolean logic and narrowing down the databases to the nursing databases and the setting up of the specific parameters guaranteed that the reviewed studies were in tune with both the clinical problem and research question. This also follows the PRISMA and Cochrane guidelines on high-quality evidence synthesis, as suggested by Moher et al. (2020).
1st article: Lee, S. H., Kim, Y. K., & Park, J. H. (2022). Effectiveness of a nurse-led lifestyle intervention on glycaemic control among older adults with Type 2 diabetes
The purpose of this paper was to examine the effects of a structured nurse-led lifestyle intervention program on glycaemic control of older adults with T2DM in South Korea. It was meant to facilitate long-term behaviour modification concerning, among others, dietary habits, physical activity, and pill-taking. A quasi-experimental research design was used and 120 participants of which were 65 years of age and above were selected and assigned to the intervention or the control group at random. According to Lee, Kim, and Park (2022), the intervention program entailed educational sessions, goal setting, and follow-up assessments every two weeks for 12 weeks. The Control group on the other hand was not given structured interventions which were offered to the other groups. Self-reported glycated haemoglobin (HbA1c), self-care practices, and quality of life indicators were measured at the beginning of the study and the end of the trial. Thus, the data showed that the subjects in the intervention group had a lower HbA1c level compared to the subjects in the control group (WMD=-1.2, 95%CI: -1.7–0.7, p<0.01), indicating better glycaemic control. Thus, self-reported improvements in upgraded eating habits and increased exercise routines were described by the participants. From the findings identified, it is clear that the type of interventions provided by the nurses to the samples of older adults plays a central role in enhancing the clinical and behavioural results for diabetes.
2nd article: Ahmed, M., Smith, R., & Jacobs, C. (2021). Community nursing interventions for elderly patients with Type 2 diabetes: A randomized controlled trial
This study aimed to determine the effectiveness of community nursing intervention in enhancing diabetes care among elderly patients in the community. Altogether 150 elderly individuals older than 65 years old with diagnosed COPD and matched according to gender, age, and smoking history were randomized into the home visitation intervention group and a control group comprising the routine outpatient group. It lasted for 16 weeks and comprised medication management help, nutritional advice, psychological evaluation, and recommendations concerning exercise. It was therefore considered as the primary measure of effect together with other secondary outcomes which included the BMI, blood pressure, and adherence level of the patient to diabetes management. According to the findings of the study, there was enhanced glycaemic control shown by a lower average HbA1c in the intervention group by 0.9 % as compared to the control group of 0.2% (p < 0.05) (Ahmed, Smith, & Jacobs, 2021). There were also other great changes seen in the level of compliance and patient satisfaction. The authors stated that community nurses have a vital role in filling this gap to support elderly patients when they go home or when it is difficult for them to be transferred to healthcare facilities.
3rd article: Johnson, L. J., & Mateo, R. (2020). A nurse-coordinated telehealth model to improve diabetes outcomes in older adults
This paper aimed to identify the effectiveness of the telehealth model which is coordinated by the nurses on older patients with type 2 diabetes, who have mobility limitations or living in distant areas. The study adopted a mixed-methods approach with 98 poorly managed older persons with diabetes (average HbA1c of more than 8 percent) receiving telehealth interventions from advanced practice nurses for six months. The approach encompassed weekly tele-consultations, remote glycaemic monitoring, medication reconciliation, and behavioural counselling. Thus, quantitative research findings showed a decrease in HbA1c levels (reduction by 1.1 %; P < 0.01) and increased Medication Adherence and Self‐Care scores. When it comes to the rationale of qualitative interviews, participants valued the convenience and the boost in morale from frequent virtual check-ins. It was also suggested that the availability of professional advice enhanced the ability to manage the condition (Johnson & Mateo, 2020). The results of this study evidenced that the proposed nurse-led telehealth model can be integrated into the treatment of elderly patients and is effective especially when the patients suffer from mobility limitations. It discusses the opportunity of having more software incorporated into the models of care that are offered to help secure the continuity and better management of diabetes among the aging.
4th article: Wu, X., Zhang, J., & Liu, Y. (2023). A culturally tailored nurse-delivered education program for glycemic control in older Chinese adults with Type 2 diabetes
This study aimed to assess the impact of a culturally appropriate, nurse-facilitated education intervention for Chinese elderly patients with type 2 diabetes. The study design used for the study was a pre-post intervention with 130 participants who were 65 years and above. It consisted of four education sessions biweekly containing subjects like traditional dietary habits, myths of diabetes in Chinese culture, the importance of compliance with medications, and exercise in Mandarin and consistent with the culture. There was even a substantial reduction of the mean HbA1c levels from 8.3 to 7.1 percent; the changes were statistically significant p < 0.01. Finally, participants also depicted an increased rate of self-efficacy in managing the disease as well as increased knowledge of complications of diabetes. The study pointed to the use of cultural consideration while delivering nursing care, as this was found to boost patient participation and improve the results (Wu, Zhang, & Liu, 2023). It suggested that culturally competent education by nurses can start a revolution in combating the disease, especially among old ethnic groups who may not have equal access to normal health information.
5th article: Green, H. E., & Mphatso, T. (2024). Evaluating integrated nursing care models in rural elderly populations with Type 2 diabetes
This descriptive-surveys study evaluated the impacts of the IMN model in health centres in rural areas of Malawi among older adults with T2 DM. In this case, the study was conducted over 12 months with the participants and consisted of 112 participants, and used an observational design, but followed the participants longitudinally. Incorporated into the practice were clinic-based checkups by regular appointments and home visits by nurses, interactions with nutritionists and social workers. Some of the services are medication adjustment, counselling on certain ways of life, peer support programs, and low-cost drugs. The results revealed the mean HbA1c was continually decreasing; on average, the lowest average HbA1c dropped from 9.1% to 7.5% at 12 Months. In addition to that, patients also claimed better appointment accessibility, better medicine consumption, and social support. This study showed that the team-based model was effective in improving care coordination and most effective where the elderly population has physical and financial constraints in gaining access to health care services (Green & Mphatso, 2024). The authors concluded that integrated nursing models are efficient for the diabetes management of elderly rural patients and stressed the need for health policy integration to support using such models within the approaches to address diabetes in the country.
The recommendations proposed by the selected studies have major significance for my practice as an adult nurse regarding elder patients with type 2 diabetes. This has enhanced my understanding of the effectiveness of lifestyle, community, and televised interventions implemented by the nurses in managing glycemia while increasing patients’ self-management skills. These approaches are commendable and are underpinned by person-centred care prescription, which is in consideration of the current NMC (Nursing and Midwifery Council, 2018) standards which encourage the use of evidence-based, compassionate care. Consequently, cultural modification, frequent follow-up, as well as the role of the multi-disciplinary team have become more discernible as crucial aspects in managing diabetes among senior citizens. The process of searching literature further paved the way to understanding the significance of a systematized approach in searching for credible evidence; and how research thinking impacts solving practical cases. Nevertheless, I would like to learn more about how such approaches can be implemented in ethnic minorities and environments with limited access to resources. Still, future research extending the time horizon in terms of sustainability and costs would be helpful to enlighten practice. In general, the implementation of research-based practices improves patient treatment with special reference to diabetic elderly patients.
Conclusion
The review process was performed using an article indexed in a routinely updated database to identify primary research studies to inform the management of type 2 diabetes in elderly patients. The databases searched were CINAHL, PubMed, and Science Direct, and the Boolean search with keywords; Type 2 diabetes, elderly, older adults, nursing intervention, glycaemic control, and evidence-based practice. Several filters were applied to the searches including the language of publication in English, type of publication as peer-reviewed primary studies, publication date from 2020 – 2025, and Participants of the study as adults, 65 years and above. Nurse-led or nursing-focused interventions were included, while pharmacological trials without a nursing component were excluded.
From the search, five high-quality primary studies were deemed relevant to the research question and included in the systematic review, but as each study focuses on distinct aspects of diabetes management, they offer unique insights into nursing-led intervention. These were lifestyle modification, community-oriented, telemedicine, culturally appropriate health promotion, and rural healthcare integration, respectively. All the studies pointed to improved HbA1c, enhanced self-management confidence, and optimized treatment compliance.
Some of the important findings include insights into the effectiveness of nurse-led strategies in encouraging positive glycaemic changes, the desirability of culturally appropriate counselling, and the appropriateness of technology in expanding the accessibility of care. Accordingly, the study establishes that adult nurses bear major responsibilities for nursing-care directions that are patient-oriented and evidence-based. Regarding community health promotion, one has to stay abreast with the findings in the literature by engaging in research and practicing reflectively.
References
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