Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control

AbstractObjectiveAssess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes.MethodWe searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants’ knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting.ResultsThis review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours ≥10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C>9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%).ConclusionsThis systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels.Practice implicationsThe data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C