Background: with increasing prevalence of diabetes in older people, it is important to understand factors that affect their
outcomes. The Informatics for Diabetes Education and Telemedicine (IDEATel) project is a demonstration project to evaluate
the feasibility and effectiveness of telemedicine with diverse, medically underserved, older diabetes patients. Subjects were
randomised to telemedicine case management or usual care. This intervention has been shown to result in improved medical
outcomes and self-efficacy. Self-efficacy refers to one’s belief that (s)he can successfully engage in a behaviour. Self-efficacy
has been shown to relate to behaviour change and glycaemic control in middle-aged individuals, but not studied in older
individuals.
Objectives: to assess whether (a) diabetes self-efficacy relates to the primary medical outcome of glycaemic control, and to
secondary outcomes (blood pressure and cholesterol), and (b) whether, after an intervention, change in diabetes self-efficacy
relates to change in these medical outcomes in a group of older, ethnically diverse individuals.
Methods: three waves of longitudinal data from participants in IDEATel were analysed.
Results: diabetes self-efficacy at baseline correlated with glycaemic control, blood pressure and cholesterol. An increase in
diabetes self-efficacy over time was related to an improvement in glycaemic control (P < 0.0001), but not in blood pressure
and lipid levels. The intervention was significantly related to improved self-efficacy over time (P < 0.0001), and both directly
(P=0.022) and indirectly through self-efficacy (P