Couple based therapy found beneficial for older adults with poorly controlled glycemia: JAMA
Researchers have found couple-based interventions useful for patients with uncontrolled type 2 diabetes (T2DM). Diabetes care tends to require wide-ranging lifestyle alterations, and, theoretically, involvement of the spouse is recommended. A recent study was conducted by Conghui Y. and colleagues which was published in the journal of JAMA Network Open.
The trial took place between September 2020 and June 2022, in 14 community health care centers across Guangzhou, China. There were 207 couples: 106 allocated to the intervention arm and 101 to the control arm. The study inclusion criteria required the patient to be 55 years of age or older and confirmed with type 2 diabetes mellitus; however, he/she should have a marital or cohabiting status with the spouse. Patients who had previously received education for diabetes or whose spouses had diabetes were excluded. Follow-up evaluation was conducted at 6 and 12 months after the intervention.
The couple-based intervention included four group education sessions at weekly intervals among both patients and spouses. Further, it featured behavior change booster telephone calls, which occurred across two months of time. Among the control subjects, the patient-only intervention also received the exact same intervention.
Both interventions focused on collective efficacy aimed at improving behaviors that enhanced their diabetes management.
Key Findings
Patient Results:
• HbA1c levels declined in both intervention and control arms during 12 months, with no significant difference between groups (β = −0.08; 95% CI, −0.57 to 0.42).
• Patients with baseline HbA1c ≥8.0% experienced lasting and statistically significant improvements in glucose control.
Spousal Outcomes:
• No significant differences were found between the two groups for quality of life, collective efficacy, or collective behavior among spouses.
Collective Efficacy and Behavior:
• Both groups also improved in both collective efficacy and patient-related behaviours; however, the magnitude of change was almost equivalent between treatment and control groups.
The overall effect of couple-based diabetes interventions was small, but the approach showed strong benefits for patients with poorly controlled glucose levels. Tailoring diabetes management to include collaborative strategies for couples, especially in cases of poor baseline control, holds promise for improving outcomes in older adults with type 2 diabetes.
Reference:
Yang C, Zhi J, Xu Y, et al. A Couple-Based Intervention for Chinese Older Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(1):e2452168. doi:10.1001/jamanetworkopen.2024.52168
