Effect of diabetes self-management education on glycemic control in Latino adults with type 2 diabetes: A systematic review and meta-analysis

Hildebrand, Janett A.; Billimek, John; Lee, Jung Ah; Sorkin, Dara H.; Olshansky, Ellen; Clancy, Steve; Evangelista, Lorraine S.

doi:10.1016/j.pec.2019.09.009

Cited by 48 publications

(48 citation statements)

References 58 publications

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“…13 Consistent non-significant findings regarding intervention intensity, length of follow-up, component of the intervention and provider type were reported in African Americans with type 2 diabetes, 13,37 and a significant effect of the individual intervention was inconsistent with a review involving Latino and African-American diabetic patients that reported non-significant reduction. 13,38 This might be because an individual-based intervention will motivate the individual to self-manage their disease condition. 39 Given that most of the interventions in the included studies were delivered in a health institution, the non-significant results might be explained by African patients' limited resources to access adequate diabetes management and the difficulties of continuing DSME in hospitals with low-income populations.…”

Section: Discussionmentioning

confidence: 99%

The effects of diabetes self‐management interventions on physiological outcomes in people living with diabetes in Africa: A systematic review and meta‐analysis

2021

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Diabetes mellitus remains a significant public health challenge, with about 463 million adults suffering from diabetes worldwide. 1 Type 1 and type 2 diabetes are the major types of diabetes mellitus. While type 1 diabetes accounts for 5%−10%, type 2 diabetes accounts for 90%−95% of overall cases of diabetes mellitus. 1,2 Diabetes mellitus is one of the most challenging chronic illnesses in health systems in Africa, 3 with 19 million people in Africa suffering from the illness in 2019. Africa accounts for the highest proportion (77%) of diabetes mellitus-related deaths worldwide due to the inaccessibility of insulin, high medical costs, and a variety of social, cultural and ethnic factors. 1,4 Self-management refers to the ability of a patient to deal with chronic illnesses, including symptoms, treatment, physical and social consequences, and lifestyle changes. 5 An international guideline has recommended diabetes self-management (DSM) interventions to enhance health in diabetes mellitus patients, with the ultimate goal of controlling glycosylated haemoglobin (HbA 1c ). 6 DSM interventions provide education and support that are related to seven American Association of Diabetes Educators self-care behaviours (the AADE 7), namely healthy eating, being active,

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Section: Discussionmentioning

confidence: 99%

The effects of diabetes self‐management interventions on physiological outcomes in people living with diabetes in Africa: A systematic review and meta‐analysis

2021

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“…The duration of the Diabetes Self-Management Education intervention was divided into two groups (≤6 months and >6 months) guided by previous meta-analysis 45 . Combining studies with a longer follow-up duration (>6 months) showed a larger HbA1c reduction (MD -0.28, 95%CI -0.52 to -0.04; P = 0.006) than those with a shorter duration (≤6 months; SMD -0.21, 95% CI -0.48 to 0.06; P = 0.13).…”

Section: Duration Of Follow Upmentioning

confidence: 99%

Effects of mindfulness‐based intervention on glycemic control and psychological outcomes in people with diabetes: A systematic review and meta‐analysis

2020

J of Diabetes Invest

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Aims/Introduction Psychological therapies have showed benefits for both glycemic control and psychological outcomes in people with diabetes. However, the effects of mindfulness‐based intervention (MBI) on glycemic control and psychological outcomes are inconsistent across studies, and the evidence for MBI has not been summarized. We aimed to identify the effects of MBI on glycemic control and psychological outcomes in people with diabetes by carrying out a systematic review and meta‐analysis. Materials and Methods Six databases (Pubmed, Embase, CINAHL, Cochrane, Web of science and PsycINFO) were searched from inception to October 2019. Randomized controlled trials of MBI for people with type 1 and type 2 diabetes were included. Two authors independently extracted relevant data and assessed the risk of bias, with a third reviewer as arbitrator. Subgroup analyses and sensitivity analyses were also carried out. Results Eight studies with 841 participants met the eligibility criteria. Meta‐analysis showed that MBI can slightly improve glycosylated hemoglobin (HbA1c; −0.25%, 95% confidence interval [CI] −0.43 to −0.07) and diabetes‐related distress (−5.81, 95% CI −10.10 to −1.52) contribute to a moderate effect size in reducing depression (standardized mean difference −0.56, 95% CI −0.82 to −0.30) and stress (standardized mean difference −0.53, CI −0.75 to −0.31). Subgroup analyses showed greater HbA1c reductions in subgroups with baseline HbA1c levels <8% and follow‐up duration >6 months. Mixed effects were observed for anxiety. Conclusions MBI appears to have benefits on HbA1c, depression, stress and diabetes‐related distress in people with diabetes. More rigorous studies with longer follow‐up duration are warranted to establish the full potential of MBI.

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“…A key finding of this study was an improvement in glycemia 6 months after the intervention: the proportion of participants having glycemic control (A1c ≤ 8) increased after the intervention from 43.9% to 60% and the mean A1c level decreased from 8.92% to 7.82%. This change is nearly twice the 0.6% reduction published in a meta-analysis of culturally appropriate diabetes education interventions among minorities that included 11 studies from across the world and 1,603 patients [ 29 ] and is higher than those reported in a systemic review of 18 DSME interventions that included 3,540 adult Latinos with type 2 diabetes where the pooled effect on A1c was a reduction of 0.24% [ 21 ]. A change in A1c level from 8.92% to 7.82% indicates that the typical study participant dropped from an average daily blood glucose of 207 to 177 mg/dL, a noticeable change in daily self-management [ 30 ].…”

Section: Discussionmentioning

confidence: 85%

“…Data suggest that culturally competent self-management educational programs, along with medical management implemented in controlled experimental designs can improve clinical outcomes through reduction in A1c, improved patient knowledge and dietary behaviors [13][14][15][16][17][18]. Several systematic reviews conclude that diabetes self-management education (DSME) programs in adults employing different delivery methods have been effective in diverse settings among general populations [19,20] including Hispanics [21].…”

Section: Introductionmentioning

confidence: 99%

Impact of a Culturally Tailored Diabetes Education and Empowerment Program in a Mexican American Population Along the US/Mexico Border: A Pragmatic Study

et al. 2020

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Background The study purpose was to deliver a diabetes education program under real world conditions and evaluate its effect on diabetes-related clinical, self-management and psychosocial outcomes among Mexican Americans residing along the US/Mexico border. Methods A pragmatic study was conducted among adult patients with diabetes in three primary care clinics located along the US/Mexico border. A bilingual culturally tailored diabetes education program incorporating hands-on participatory techniques was delivered in 4 - 8 weekly group sessions. Clinical, self-management and psychosocial outcomes were evaluated pre- and post-intervention with surveys and medical record review. Results A total of 209 participants were enrolled; mean age was 58.9 years (range 23 - 94, standard deviation: 11.2); 68.4% were female; 91.1% were Hispanic. Significant improvements were observed in glycated hemoglobin (-1.1%, P < 0.001, n = 79), total cholesterol (-17.2 mg/dL, P = 0.041, n = 63), glucose self-monitoring (+1.3 times a week, P = 0.021, n = 115), exercise less than once a week (-18.2%, P < 0.001, n = 129), nutritional behavior (+2.23, P < 0.001, n = 115), knowledge (+1. 83, P < 0.001, n = 141) and diabetes-related emotional distress (-7.32, P = 0.002, n = 111). Benefits were observed with attendance rates as low as 50%. Conclusion A clinic-based culturally competent diabetes education/self-management program resulted in significant improvements in outcomes among Hispanic participants. Experimentally tested culturally appropriate interventions adapted for real world situations can benefit Mexican American diabetic patients even when attendance is imperfect.

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Effect of diabetes self-management education on glycemic control in Latino adults with type 2 diabetes: A systematic review and meta-analysis

Cited by 48 publications

References 58 publications

The effects of diabetes self‐management interventions on physiological outcomes in people living with diabetes in Africa: A systematic review and meta‐analysis

The effects of diabetes self‐management interventions on physiological outcomes in people living with diabetes in Africa: A systematic review and meta‐analysis

Effects of mindfulness‐based intervention on glycemic control and psychological outcomes in people with diabetes: A systematic review and meta‐analysis

Impact of a Culturally Tailored Diabetes Education and Empowerment Program in a Mexican American Population Along the US/Mexico Border: A Pragmatic Study

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