Purpose: This study aimed to 1) determine the current scenario in self-management of diet therapy in elderly diabetic patients living alone and its influencing factors, and 2) offer suggestions regarding nursing interventions for effective self-management of diet therapy.

Method: The participants were 16 type 2 diabetic outpatients aged 70 years or older and living alone. Semi-structured interviews were conducted for data collection and qualitative data analyses were performed.

Results: The self-management approaches were classified as "Low," "Moderate," and "High." The following 10 main factors associated with self-management were extracted: social support, sense of isolation, economic conditions, knowledge, awareness of the necessity of self-management, preparation of meals, feelings of burden, enjoying eating, devising and integrating self-management into life, and results of self-management. The group with particularly low self-management was characterized by men with a sense of loneliness who rarely interacted with others.

Conclusion: The results confirmed the importance of nursing support for the promotion of self-management-considering social support in particular, among other relevant factors-as well as measures for improving the quality of life in elderly diabetic patients living alone by reducing the burden and emphasizing enjoying eating. In particular, men with a sense of loneliness who rarely interact with others need to be given more attention and support.

BACKGROUND：In Japan, the annual rate of treatment interruption among patients with type 2 diabetes mellitus（T2DM）is approximately 8%. Complications often develop and progress when treatment is resumed；hence, countermeasures are required urgently. In T2DM, treatment satisfaction is associated with prevention of treatment interruption. Therefore, factors that increase patient satisfaction in T2DM management should be identified.AIMS：This study aimed to define the predictable relationship between treatment satisfaction and self-monitoring ability in outpatients with T2DM.METHODS：In a general hospital in Japan, we collected outpatient data through a questionnaire survey and the electronic medical records database. Factors associated with treatment satisfaction were identified using multivariate logistic regression analysis. The Research Ethics Committee of the hospital approved our study protocol.RESULTS：We enrolled 244 patients（mean age, 65.9±11.2 years；male, 60.2%；female, 39.8%；mean HbA1c value, 7.62%±1.22%）, with 160（65.6%）classified as the high-value group and 84（34.4%）as the low-value group in terms of satisfaction. Self-monitoring ability was the factor that independently correlated with high treatment satisfaction（odds ratio［OR］, 1.14；95% confidence interval［CI］, 1.07-1.23）.CONCLUSIONS：Supporting self-monitoring ability is important for high treatment satisfaction among patients with T2DM.