Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis
By A. Steinsbekk, L. Rygg, M. Lisulo, M. B. Rise, A. Fretheim. BMC Health Services Research, 2012
659 citations recorded by the source corpus.
BackgroundDiabetes self-management education (DSME) can be delivered in many forms. Group based DSME is widespread due to being a cheaper method and the added advantages of having patient meet and discuss with each other. assess effects of group-based DSME compared to routine treatment on clinical, lifestyle and psychosocial outcomes in type-2 diabetes patients.MethodsA systematic review with meta-analysis. Computerised bibliographic database were searched up to January 2008 for randomised controlled trials evaluating group-based DSME for adult type-2 diabetics versus routine treatment where the intervention had at least one session and =/>6 months follow-up. At least two reviewers independently extracted data and assessed study quality.ResultsIn total 21 studies (26 publications, 2833 participants) were included. Of all the participants 4 out of 10 were male, baseline age was 60 years, BMI 31.6, HbA1c 8.23%, diabetes duration 8 years and 82% used medication. For the main clinical outcomes, HbA1c was significantly reduced at 6 months (0.44% points; P = 0.0006, 13 studies, 1883 participants), 12 months (0.46% points; P = 0.001, 11 studies, 1503 participants) and 2 years (0.87% points; P < 0.00001, 3 studies, 397 participants) and fasting blood glucose levels were also significantly reduced at 12 months (1.26 mmol/l; P < 0.00001, 5 studies, 690 participants) but not at 6 months. For the main lifestyle outcomes, diabetes knowledge was improved significantly at 6 months (SMD 0.83; P = 0.00001, 6 studies, 768 participants), 12 months (SMD 0.85; P < 0.00001, 5 studies, 955 participants) and 2 years (SMD 1.59; P = 0.03, 2 studies, 355 participants) and self-management skills also improved significantly at 6 months (SMD 0.55; P = 0.01, 4 studies, 534 participants). For the main psychosocial outcomes, there were significant improvement for empowerment/self-efficacy (SMD 0.28, P = 0.01, 2 studies, 326 participants) after 6 months. For quality of life no conclusion could be drawn due to high heterogeneity. For the secondary outcomes there were significant improvements in patient satisfaction and body weight at 12 months for the intervention group. There were no differences between the groups in mortality rate, body mass index, blood pressure and lipid profile.ConclusionsGroup-based DSME in people with type 2 diabetes results in improvements in clinical, lifestyle and psychosocial outcomes.
Subfields: Endocrinology, Diabetes and Metabolism, General Health Professions
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In Endocrinology, Diabetes and Metabolism
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Citations in the corpus
- Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics (2015, background): “DSME/S improves hemoglobin A1c (HbA1c) by as much as 1% in people with type 2 diabetes.(3,7,16-20) Besides this important reduction, DSME has a positive effect on other clinical, psychosocial, and behavioral aspects of diabetes.”
- 5. Lifestyle Management: Standards of Medical Care in Diabetes—2019 (2018, background): “ciated with improved diabetes knowledge and self-care behaviors (8), lower A1C (7,9–11), lower self-reported weight (12,13), improved quality of life (10,14), reduced all-cause mortality risk (15), healthy coping (16,17), and reduced health care costs (18–20).”
- Experiences of Patients With a Diabetes Self-Care App Developed Based on the Information-Motivation-Behavioral Skills Model: Before-and-After Study (2019, result): “Increase in social motivation with using the bulletin board is consistent with the findings of previous studies in which the participants shared their know-how about diabetes self-care and feelings with other patients with the same disease [25-27].”