Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Glycated hemoglobin (HbA1c) control is a crucial goal in the management of type 2 diabetes mellitus (T2DM), requiring lifelong commitment and family support. This study aimed to assess the effectiveness of family-based diabetes management intervention on HbA1c among adults with T2DM. Methods: From inception up to 2022, a comprehensive literature search was conducted across PubMed, ProQuest, Scopus, CORE, and the Cochrane Library. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Effect sizes were calculated using standard deviations (SD), while the degree of heterogeneity was evaluated using the Higgins I2 test. Subgroup analyses were performed to explore factors contributing to sources of heterogeneity among trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered with PROSPERO CRD42022384034. Results: A total of 18 randomized controlled trials (RCTs) involving 2815 participants indicated that family-based diabetes management intervention had a statistically significant impact on improving HbA1c (Mean Difference [MD] = −.47; 95% Confidence Interval [CI]: −.64 to −.30, p < .001) with a moderate level of heterogeneity (I2 = 59%). Subgroup analysis indicated that family-based diabetes management intervention among adults with T2DM in developing regions was more effective in improving HbA1c levels compared to developed countries. Conclusion: Family-based diabetes management interventions improved HbA1c. Further research is required to develop diabetes management strategies with a family focus that clearly defines the family’s involvement.

The Medicine Wheel as a public health approach to lifestyle management interventions for indigenous populations in North America

“…Comparing these two studies in Indigenous populations in North American, the dilemma of study heterogeneity reported by Baig et al ( 17 ) becomes clear. A more recent review of family-based randomized control trials among adults with type 2 diabetes showed moderate heterogeneity across trials ( n = 18) and reported similar issues related to variable family involvement across trials ( 19 ). However, results did show significant improvements in A1c levels with greater improvements in developing areas compared to developed countries ( 19 ).…”

Patient-centered care in diabetes care-concepts, relationships and practice

“…Specifically, peer support provided in small group settings, short-term interventions, and weekly meetings may yield more favorable outcomes[ 120 ]. Empirical studies of peer support programs indicate that prolonged participation in peer support is beneficial for reducing A1C levels and improving QoL[ 121 ] and distress[ 122 ], especially among individuals with a lower socioeconomic status[ 120 , 123 - 125 ]. Additionally, volunteers who serve as peer supporters (those who themselves have diabetes) may achieve better health outcomes due to their involvement in relevant activities[ 126 ].…”