title: Provision of counseling on diabetes self-management: are there any age disparities?
abstract: 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).
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family & Community Medicine, Scott & White, College of Medicine, Texas A&M Health Science Center, Temple, TX 76504, USA. sforjuoh@swmail.sw.org
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Forjuoh
authors.forename: Charles
authors.initials: C
authors.lastname: Huber
authors.forename: Jane N
authors.initials: JN
authors.lastname: Bolin
authors.forename: Shivajirao P
authors.initials: SP
authors.lastname: Patil
authors.forename: Manisha
authors.initials: M
authors.lastname: Gupta
authors.forename: Janet W
authors.initials: JW
authors.lastname: Helduser
authors.forename: Sonia
authors.initials: S
authors.lastname: Holleman
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D016009:Chi-Square Distribution; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012307:Risk Factors; D012648:Self Care; D013781:Texas
chemical_list: D015415:Biomarkers