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Diabetes mellitus (DM) is a widespread chronic metabolic illness around the world, and prolonged hyperglycemia not only causes a variety of problems but also affects metabolic and immunological activities, compromising patients' nutritional status. The Listen-Establish-Adopt-Reinforce-Name-Strengthen (LEARNS) nursing paradigm, based on a patient-centered concept, is a new strategy that aims to foster self-directed learning, improve nurse-patient engagement, increase self-care awareness, and encourage two-way communication. This study looked at the effect of LEARNS nursing on the nutritional status and general health indices of older persons with DM. A total of 168 hospitalized patients aged 60 years or older were involved, with 89 in the LEARNS group and 79 receiving standard treatment. Propensity score matching was used to reduce confounding bias, and the intervention lasted four weeks. After the intervention, patients in the LEARNS group had significantly improved glycemic markers, including reduced HbA1c, FPG, and 2hPG values (P < 0.05). Self-management capacity improved, as evidenced by higher scores on the Chinese Diabetes Management Self-Efficacy Scale. Nutritional indicators such as serum albumin (ALB), hemoglobin (HGB), total serum protein (TSP), and transferrin (TRF) increased, whereas the proportion of high-risk patients identified by the PG-SGA malnutrition score dropped. Quality-of-life assessments also showed improvement, with higher Health-Promoting Lifestyle Profile (HPLP-II) and lower Pittsburgh Sleep Quality Index (PSQI) ratings. The LEARNS group had a considerably higher patient satisfaction rate (92.13%) compared to the control group (P < 0.05). Overall, the data demonstrate that the LEARNS nursing model improves nutritional status, self-management efficacy, and quality of life in senior diabetic patients while also improving glucose control. The study's shortcomings include a single-center design and a short follow-up time. More studies with larger samples and longer periods of observation are needed to confirm long-term effects.