The impact of patient support and health education on diabetes management and glycemic control

J Med Life. 2024 Oct;17(10):908-917. doi: 10.25122/jml-2024-0290.

Abstract

Diabetes mellitus is a chronic and complex medical condition that can lead to significant morbidity and mortality. Maintaining an adequate blood glucose level is important for patients with diabetes, and to improve glycemic control, patients need proper support and health education, which are essential components of comprehensive diabetes care. We used a rigorous approach based on the PRISMA and Cochrane Handbook principles, specifically focusing on randomized controlled trials (RCTs) published in English from 2005 onwards. The statistical analysis was conducted using the RevMan software. Pooled risk ratios were calculated for dichotomous data, whereas mean differences were calculated for continuous data. Heterogeneity and publication bias were also evaluated. From an initial pool of 544 records, 368 studies were examined after eliminating duplicates. Ultimately, 24 studies were deemed suitable based on the inclusion criteria. These studies involved 2437 participants in the intervention group and 2305 people in the control group. The quality assessment indicated that 41.7% of the studies were categorized as low risk, 16.7% as high risk, and 41.7% had certain concerns regarding bias. The analyses revealed noteworthy decreases in HbA1c levels in the intervention group at several time points, particularly showing improvements after 3 months. Egger's regression indicated the presence of possible publication bias. The results emphasize the crucial impact of health education and mentorship interventions on enhancing glycemic control in individuals with type 2 diabetes. Interventions focused on empowering patients proved to be especially effective in enhancing diabetes management outcomes.

Keywords: DSMES, Diabetes Self-Management Education and Support; HbA1c, Glycated Hemoglobin; ROB v2, Risk of Bias Version 2; SEDM, Structured Education in Diabetes Management; T2DM, Type 2 Diabetes Mellitus; Type 2 diabetes mellitus (T2DM); diabetes management; educational programs; glycemic control; patient support.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / therapy
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Glycemic Control* / methods
  • Health Education*
  • Humans
  • Patient Education as Topic / methods

Substances

  • Glycated Hemoglobin
  • Blood Glucose