The aim of this pilot study is to test the hypothesis that different diabetes self-management strategies can improve glycemic control in elderly patients with diabetes. Patients with suboptimal glycemic control were selected from outpatient clinic and randomly assigned to (1) breakfast meal-replacement; (2) peer-support; and (3) group session only groups. HbA1c reductions of 0.8% and 1.01% were noted from the baseline value to 12 weeks in the meal-replacement and peer-support groups, respectively. In addition, greater body weight reduction was observed in the meal replacement and peer-support groups. This reduction was associated with not only nutritional knowledge improvement but also decreased daily carbohydrate intake. A combination of conventional disease management education and peersupport or breakfast meal-replacement was found to be useful in elderly diabetic patients in terms of their ongoing diabetes self-care. Such combinations are easy to implement and effective for achieving glycemic control.
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