Gestire il diabete di tipo 2 nell'anzianità. Un'analisi sistematica e sintesi tematica della letteratura

Purpose: To systematize evidences related to self-management practices of older patients with type 2 diabetes, with particular reference to barriers and facilitators. Methods: Electronic databases were searched without year or language restrictions and independently screened and analyzed by two researchers following the SIGN evaluation checklist. Barriers and facilitators to self-care were thematically synthetized. Results: 17 articles were included. Five overarching themes for barriers and facilitators to self-care were identified: disease-related aspects, socio-demographic aspects, psychological aspects, doctor-patient aspects and social community aspects. In particular, diabetes symptoms, comorbidities and chronicity of treatment appeared to hamper self-care practices. On the contrary, working on personal resources and engaging peers and family has been reported to strengthen self-care behaviors. Finally, communication with the doctor was reported as the primary source of information and education to sustain self-care behaviors. Conclusions: Since engaging older type 2 diabetes patients in their care management is a multifaceted challenge that encompasses different potentially modifiable levels of action (e.g., individual, relational, social), solutions considering these levels should be considered. The need for a targeted intervention that would consider both ageing and diabetes-related difficulties is highlighted.