Effectiveness of Self-Management Supporting Programs Among People with Type 2 Diabetes Mellitus: A Systematic Review
Article Sidebar
Main Article Content
Abstract
OBJECTIVES: This systematic review aims to evaluate the impact of self-management support programs on clinical, behavioral, and psychosocial outcomes among adults with T2DM.
MATERIALS AND METHODS: This systematic review evaluates the effectiveness of self-management support programs on clinical, behavioral, and psychosocial outcomes among T2DM patients. A comprehensive literature search was conducted across PubMed, EMBASE, Cochrane Library, CINAHL, and Web of Science for randomized controlled trials (RCTs) published between 2012 and 2024. Eligible studies included adult T2DM patients participating in self-management interventions and reporting at least one relevant outcome, such as glycemic control (HbA1c), self-care behaviors, quality of life, or psychosocial factors. Methodological quality was assessed using the Cochrane Risk of Bias tool.
RESULTS: Of 2,485 studies identified, 15 met inclusion criteria. Self-management support programs significantly improved HbA1c levels, with a mean reduction of 0.48% (95% CI: -0.64 to -0.32) compared to standard care. Multi-component interventions (including education, behavioral strategies, and technology support) were more effective than single-component programs. Technology-enabled interventions demonstrated comparable efficacy to traditional face-to-face programs. Culturally tailored approaches were particularly beneficial for minority ethnic groups. However, the long-term sustainability of these interventions beyond 12 months remains uncertain.
CONCLUSION: Self-management support programs effectively enhance glycemic control and self-care behaviors, especially when multi-faceted, technologysupported, and culturally adapted. Future research should focus on long-term effectiveness, implementation in resource-limited settings, and standardized reporting of behavioral and psychosocial outcomes.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee. IDF Diabetes Atlas. 10th ed. Brussels: International Diabetes Federation; 2021.
Aekplakorn W, Chariyalertsak S, Kessomboon P, et al. Prevalence and management of diabetes and metabolic risk factors in Thai adults: The Thai national health examination survey IV, 2009. Diabetes Care 2011;34(9):1980-5. doi:10.2337/dc11-0099.
Bommer C, Sagalova V, Heesemann E, et al. Global eco nomic burden of diabetes in adults: projections from 2015 to 2030. Diabetes Care 2018;41(5):963-970. doi: 10.2337/dc171962.
Funnell MM, Brown TL, Childs BP, et al. National standards for diabetes self-management education. Diabetes Care 2012;35(Suppl 1):S101-S108. doi:10.2337/dc12-s101.
Powers MA, Bardsley JK, Cypress M, et al. Diabetes self-management education and support in adults with type 2 diabetes: A consensus report. Diabetes Care 2020;43(7): 1636-1649. doi:10.2337/dci20-0023.
Chowdhury HA, Harrison CL, Siddiquea BN, et al. The effectiveness of diabetes self-management education intervention on glycaemic control and cardiometabolic risk in adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis. PLoS One 2024;19(2):e0297328. doi:10.1371/journal.pone.0297328.
Asmat K, Dhamani K, Gul R, Froelicher ES. The effectiveness of patient-centered care vs. usual care in type 2 diabetes self-management: A systematic review and meta-analysis. Front Public Health 2022;10:994766. doi:10.3389/ fpubh.2022.994766.
Kerr D, Ahn D, Waki K, et al. Digital interventions for self management of type 2 diabetes mellitus: Systematic literature review and meta-analysis. J Med Internet Res 2024;26:e55757. doi:10.2196/55757.
Norris SL, Engelgau MM, Narayan KM. Effectiveness of self-management training in type 2 diabetes: A systematic review of randomized controlled trials. Diabetes Care 2001;24(3):561-587. doi:10.2337/diacare.24.3.561.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BM. 2021;372:n71. doi.10.1136/bmj.n71.
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898. doi:10.1136/bmj.l4898.
Yu X, Wang Y, Liu Z, et al. Technological functionality and system architecture of mobile health interventions for diabetes management: a systematic review and meta-analysis of randomized controlled trials. Front Public Health 2025;13:1549568. doi: 10.3389/fpubh.2025.1549568.
Moschonis G, Siopis G, Jung J, et al. Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. Lancet Digit Health. 2023;5(3):e134-e143. doi: 10.1016/S2589-7500(22)00233-3.
Quinn CC, Shardell MD, Terrin ML, et al. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care 2011;34(9):1934 1942.doi:10.2337/dc11-0366.
Anjali M, Nazareth I, Petersen I. Effectiveness of diabetes self-management education on distress and HbA1C among Indian type 2 diabetes mellitus patients: a randomized controlled trial. J Family Med Prim Care 2023;48(5):701-8. doi: 10.4103/ijcm.ijcm_843_22.
Gathu CW, Shabani J, Kunyiha N, et al. Effect of diabetes self-management education on glycaemic control among type 2 diabetic patients at a family medicine clinic in Kenya: A randomised controlled trial. Afr J Prim Health Care Fam Med 2018;10(1):e1-e9. doi: 10.4102/phcfm.v10i1.1762.
Aminuddin HB, Jiao N, Jiang Y, et al. Effectiveness of smartphone-based self-management interventions on self efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with type 2 diabetes: A systematic review and meta-analysis. Int J Nurs Stud 2021;116:103286. doi:10.1016/j.ijnurstu.2019.02.003.
Greenwood DA, Gee PM, Fatkin KJ, et al. A systematic review of reviews evaluating technology-enabled diabetes self management education and support. J Diabetes Sci Technol 2017;11(5):1015-27. doi:10.1177/1932296817713506.
Lee JY, Wong CP, Lee SWH. m-Health views and perception among Malaysian: findings from a survey among individuals living in Selangor. Mhealth 2020:6:6. doi: 10.21037/mhealth.2019.09.16. eCollection 2020.
Pillay J, Armstrong MJ, Butalia S, et al. Behavioral programs for type 2 diabetes mellitus: A systematic review and network meta-analysis. Ann Intern Med 2015;163(11):848-860. doi:10.7326/M15-1400.
Doupis J, Festas G, Tsilivigos C, et al. Smartphone-based technology in diabetes management. Diabetes Ther 2020;11(3):607-19. doi:10.1007/s13300-020-00768-3.
American Diabetes Association Professional Practice Committee. Standards of care in Diabetes—2023. Diabetes Care 2023;46(Suppl 1):S1-S291.
Bandura A. Social cognitive theory: An agentic perspective. Annu Rev Psychol 2001;52:1-26. doi:10.1146/annurev. psych.52.1.1.
