Effectiveness of Communication-Based Interventions on Self-Management in Older Adults with Type 2 Diabetes Mellitus: A Systematic Review
DOI:
https://doi.org/10.31674/ijbb.2025.v03i02.005Abstract
Background: Type 2 diabetes mellitus (T2DM) is a common chronic condition among older adults, often accompanied by multimorbidity and cognitive decline, which can hinder effective self-management. Communication-based interventions, including face-to-face, digital, and telecommunication approaches, have been used to support self-care behaviors, but evidence on their effectiveness in older adults remains limited. This study aimed to evaluate the effect of communication-based interventions on self-management in older adults with T2DM.
Methods: A targeted search was conducted in PubMed, Scopus, and ScienceDirect for randomized controlled trials (RCTs) published between 2021 and 2026 that evaluated the effects of communication-based interventions on self-management in older adults with T2DM. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for RCTs.
Results: Ten studies involving participants from various countries were included, with sample sizes ranging from 36 to 742. Communication interventions included face-to-face education, digital communication, and telecommunication. These interventions improved self-management behaviors, with approaches combining regular communication, personalized feedback, and behavioral support showing the highest effectiveness.
Conclusion: Communication-based interventions effectively enhance self-management in older adults with T2DM. These findings support the development of targeted programs that promote sustained self-care and improve patient health outcomes in this high-risk population.
Keywords:
Communication Intervention, Self-Management, Older Adults, Type 2 Diabetes MellitusReferences
Abdulsalam, F. I., Srichaijaroonpong, S., Phoosuwan, N., & Phoosuwan, N. (2025). Effectiveness of a health literacy and diabetes self-management education (DSME) improvement program for people with type 2 diabetes mellitus: A community-based quasi-experimental study in Thailand. Journal of Diabetes Research, 2025. https://doi.org/10.1155/jdr/2640702
Asante, E., Carter, G., Mcaneney, H., Bam, V., Sarfo-Kantanka, O., & Prue, G. (2025). Nurse-led mobile phone intervention to promote self-management in type 2 diabetes in Ghana: A randomized controlled trial. The Science of Diabetes Self-Management and Care 2025. https://doi.org/10.1177/26350106241293113
Asmat, K., Froelicher, E. S., Dhamani, K. A., Gul, R., & Khan, N. (2024). Effect of patient-centered self-management intervention on glycemic control, self-efficacy, and self-care behaviors in South Asian adults with type 2 diabetes mellitus : A multicenter randomized controlled trial. Effect of patient-centered self-management. Journal of Diabetes, July. https://doi.org/10.1111/1753-0407.13611
Bretschneider, M. P., Barbara, A., Lenka, Š., Kl, J., Schwarz, P. E. H., Med, P., & Bretschneider, M. P. (2025). Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial. Journal of Medical Internet Research, 27, 1–14. https://doi.org/10.2196/68648
Cheng, Z., Xiao, Q., Xu, Y., Tan, L., Qu, W., Shen, W., & Luo, Y. (2025). Effectiveness of patient-centred care in self-management of type 2 diabetes: A systematic review and meta-analysis. BMC Health Services Research. https://doi.org/10.1186/s12913-025-12539-6
Clara, F., Hui, J., Oka, P., Dambha-Miller, H., & Tan, N. C. (2021). The association between self-efficacy and self-care in essential hypertension: A systematic review. BMC Family Practice, 1–12. https://doi.org/10.1186/s12875-021-01391-2
Egele, V. S., Klopp, E., & Stark, R. (2025). How valid is Bandura’s social cognitive theory to explain physical activity behavior? European Journal of Investigation in Health, Psychology, and Education. https://doi.org/10.3390/ ejihpe15020020
Gregg, E. W., & Shaw, J. E. (2017). Global health effects of overweight and obesity. Diabetes Care, 40(9), 1217–1225. https://doi.org/10.2337/dc17-0859
Iroegbu, C., Tuot, D. S., Lewis, L., & Ann, L. (2025). The influence of patient-provider communication on management among patients with chronic illness: A systematic mixed studies review. Journal of Advanced Nursing, 1678–1699. https://doi.org/10.1111/jan.16492
Kerr, D., Ahn, D., Waki, K., Wang, J., Breznen, B., Klonoff, D. C., & Kerr, D. (2024). Digital interventions for self-management of type 2 diabetes mellitus: Systematic literature review and meta-analysis. Journal of Medical Internet Research, 26. https://doi.org/10.2196/55757
Kılınç, E., İrem, İ., Özdemir, N., & Aydın, Ş. (2025). The effect of tele-nursing based motivational interviewing on self-efficacy, self-management and metabolic control parameters in individuals with type 2 diabetes: Randomized controlled study. Irish Journal of Medical Science, 563–573. https://doi.org/10.1007/s11845-025-03916-5
Leksell, J., Toft, E., Rosman, J., Eriksson, J. W., Fischier, J., & Lindholm-Olinder, A. (2023). Virtual clinic for young people with type 1 diabetes: A randomised wait-list controlled study. BMC Endocrine Disorders, 1–9. https://doi.org/10.1186/s12902-023-01516-x
Leon, N., Namadingo, H., Cooper, S., Bobrow, K., Mwantisi, C., Nyasulu, M., Sicwebu, N., & Crampin, A. (2021). Process evaluation of a brief messaging intervention to improve diabetes treatment adherence in sub-Saharan Africa. BMC Public Health, 1–13. https://doi.org/10.1186/s12889-021-11552-8
Liu, Y., Xiao, X., Peng, C., Zhao, T., Wu, Y., Yu, W., Ou, L., Chen, X., Wu, X., Xu, D. R., & Liao, J. (2021). Development and implementation of couple-based collaborative management model of type 2 diabetes mellitus for community-dwelling Chinese older adults: A pilot randomized trial. Frontiers in Public Health, 9(July). https://doi.org/10.3389/fpubh.2021.686282
Mahmud, A. Al, Joachim, S., Jayaraman, P. P., Learmonth, C., Tyagi, S., Rahim, A., Forkan, M., Shuakat, M., & Wickrama, N. (2026). Digital health interventions to support chronic disease management: Systematic scoping review. JMIR MHEALTH AND UHEALTH, 14, 1–23. https://doi.org/10.2196/63742
Mathiesen, A. S., Zoffmann, V., Skytte, T. B., Jakobsen, J. C., Gluud, C., Lindschou, J., & Rasmussen, B. (2021). Guided self-determination intervention versus attention control for people with type 2 diabetes in outpatient clinics: A protocol for a randomised clinical trial. BMJ. https://doi.org/10.1136/bmjopen-2020-047037
Mehralian, G., Yusefi, A. R., Dastyar, N., & Bordbar, S. (2023). Communication competence, self-efficacy, and spiritual intelligence: Evidence from nurses. BMC Nursing, 1–9. https://doi.org/10.1186/s12912-023-01262-4
Morton, K., Dennison, L., May, C., Murray, E., Little, P., McManus, R. J., & Yardley, L. (2017). Using digital interventions for self-management of chronic physical health conditions: A meta-ethnography review of published studies. Europe PMC Funders, 100(4), 616–635. https://doi.org/10.1016/j.pec.2016.10.019.Using
Patel, M. R., Zhang, G., Heisler, M., Piette, J. D., Resnicow, K., Choe, H. M., Shi, X., & Song, P. (2024). A randomized controlled trial to improve unmet social needs and clinical outcomes among adults with diabetes. 0123456789, 2415–2424. https://doi.org/10.1007/s11606-024-08708-8
Thuy, T., & Dinh, H. (2023). Exploring the relationships between health literacy, social support, self-efficacy and self- management in adults with multiple chronic diseases. BMC Health Services Research, 5, 1–10. https://doi.org/10.1186/s12913-023-09907-5
Xue, H., Zhang, L., Shi, Y., & Zhang, H. (2025). The effectiveness of digital health intervention on glycemic control and physical activity in patients with type 2 diabetes: A systematic review and meta-analysis. Frontiers in Digital Health, July, 1–13. https://doi.org/10.3389/fdgth.2025.1630588
World Health Organization. (2024). Diabetes. https://www.who.int/health-topics/diabetes
Zamanillo-campos, R., Fiol-deroque, M. A., Serrano-ripoll, M. J., Llobera-canaves, J., Taltavull-aparicio, J. M., Leiva-rus, A., Ripoll-amengual, J., Angullo-martínez, E., María, I., Masmiquel-comas, L., Konieczna, J., Zaforteza-dezcallar, M., Boronat-moreiro, M. A., Mira-martínez, S., Gervilla-garcía, E., & Ricci-cabello, I. (2025). Impact of an SMS intervention to support type 2 diabetes DiabeText clinical trial. British Journal of General Practice, July.
