Introduction
Type 2 diabetes is an illness characterized by elevated glucose levels caused by a metabolic disorder that leads to a decline in insulin production. According to Saltiel (2001), diabetes is a condition in which abnormalities in lipid and carbohydrate metabolism result in elevations in serum glucose. Engagement in certain behaviors can result in effective control. These include exercise, smoking cessation, and healthy eating habits. It is important to apply the aforementioned strategies to limit the incidence of complications. The prevalence of unhealthy behavior has facilitated the increase in the prevalence of individuals suffering from type 2 diabetes.
Research Question
Is self-management education beneficial in the management of type 2 diabetes?
Objective Method
This systematic review is intended to assess the effectiveness of self-management education in type 2 diabetes patients, as shown in Table 1.
Search Strategies
The collection and assessment of articles were conducted by analyzing published articles from a variety of electronic databases. The reviewed sources included ProQuest, PubMed, and ScienceDirect, using keywords such as self-care, diabetes mellitus, self-management, and education. The inclusion criteria were research associated with diabetes self-management, the effects of diabetes education, and the use of the English language. The articles that were excluded included publications from news outlets, non-academic websites, and those that used languages other than English.
Method of Review
It is also worth noting that randomized control trials, cross-sectional studies, and quasi-experimental studies were prioritized during the search. The identified data was collected, grouped, and analyzed for relationships with the subject matter. A total of eight articles were identified through the selection process. Upon further examination 3 met the aforementioned inclusion criteria and were used in the review process, as shown in Figure 1.
Description and Characteristics of Selected Studies
The first study, which was conducted by Rusdiana et al. (2018), is a quasi-experiment focused on type 2 Diabetic Patients. The patients were exposed to a three-month intervention that included eight weeks of education on self-management of diabetes and four weeks of practice on the lessons taught (Rusdiana et al., 2018). The advice provided on diet management was based on information from international diabetes management organizations. It applied a systematic sampling technique. Participants attended a DSME program on self-management guidelines. The effect was assessed by measuring FBS, Hba1c, and BMI, and a T-test statistical analysis was conducted to evaluate the data. There was a significant difference in Hba1c values between pre and post-education in type 2 diabetics (P <0.005) (Rusdiana et al., 2018). The researchers concluded that diabetes self-management effectively reduces Hba1c levels in type2 diabetics. The study limitations include a short interval between pre and post-test and bias in the end-line survey.
The second study conducted by Rasoul et al. (2019) applied a quasi-experimental design focused on diabetic patients. The researchers estimated that 60 sessions were sufficient to educate the target population (Rasoul et al., 2019). Twenty lessons that highlighted vital aspects of diet were posted on the weblog, after which twenty regarding exercise, ten on medication, five for glucose measurement, and five for adhering to physician advice were added (Rasoul et al., 2019). The effects were assessed through the administration of a diabetes quality of life questionnaire. The data was analyzed using the Mann-Whitney technique, T-test, and Paired T-test. After the intervention, the test and control groups differed in terms of waist circumference, FBS, and BMI. There is a positive effect of weblog-based self-management on the quality of life of diabetic patients. The study limitation was that only patients that had the ability to use the internet were included in the study.
The final study was carried out by Bjonstad et al. (2021) who carried out a multicenter clinical trial among type 2 diabetes youth. The effects of the intervention were assessed through the evaluation of BMI, Hba1c levels, and the incidence of complications. Kaplan-Meier estimates, Cox proportional hazards regression models, and SAS software were used in statistical analysis. The researchers noted that the median glycated hemoglobin level rose over time, and the percentage of participants with non-diabetes levels decreased from 75% to 19% after 15 years (Bjornstad et al., 2021). In addition, there was no significant change in the rate of hypertension and dyslipidemia observed among the study participants. However, there was an increase in the prevalence of kidney disease and nerve disease.
The researchers concluded that the onset of type 2 diabetes in youth is associated with an increased risk of complications. They further noted that minority races and ethnic groups are adversely affected by diabetes-linked complications. The study’s main limitation was the small number of medications approved by the FDA for use in youth with type 2 diabetes. Its strengths included the large sample of participants and the diversity in the cohort, which made the findings representative of the general population. The main weakness was the fact that the study did not explore the effects of aggressive management of hyperglycemia in diabetic patients.
Table 1: Data Extraction
Methodological Quality
The study reviewed high-quality sources such as ProQuest, PubMed, and ScienceDirect. The keywords that were used in the study such as self-care, diabetes mellitus, self-management, and education facilitated the identification of reputable peer-reviewed articles. The inclusion criteria also allowed for the inclusion of evidence-based studies. The articles that were excluded, such as publications from news outlets, non-academic websites, and those that used languages other than English maintained the study’s rigor.
Discussion
The main objective of conducting this systematic review was to evaluate the effectiveness of Diabetes Self-management Education and Support (DSME) among type 2 diabetes patients. The variability of DSME was seen in the time periods, number of sessions, and techniques applied. The three studies analyzed in the review demonstrated homogenous findings. Rusdiana et al. (2018) prove that educational interventions significantly reduce the levels of Hba1c in diabetes patients. Rasoul et al. (2019) demonstrate the beneficial effects of weblog-based self-management interventions among individuals diagnosed with diabetes. Finally, Azami et al. (2018) show how nurse-led education interventions lead to significant improvements in the quality of life of diabetic patients.
Limitations
There were some limitations associated with conducting the systematic review. In one of the studies, participants were followed up for a limited period. In addition, one of the studies only included patients that had the ability to use the internet. It is vital to note that one of the studies applied a short interval between pre and post-test and there was bias in the end-line survey.
Conclusion
The importance of Diabetes Self-management Education and Support in the management of type 2 diabetes is a foregone conclusion. The evidence indicates that equipping patients with the skills they require to effectively address their illnesses results in improved outcomes. Education facilitates the identification of complications, evaluation of an intervention’s efficiency, and the adoption of healthy behaviors. It is vital that type 2 diabetes patients are exposed to the information they require to improve the quality of their lives and avoid the debilitating complications associated with the illness.
Implication
The management of type 2 diabetes should focus on educating individuals on the effects of the illness and the lifestyle changes that must be implemented to ensure effective glycemic control. It is evident that patient education initiatives significantly enhance the overall well-being of patients because they are better equipped to identify signs and symptoms of complications, which then prompts them to seek medical attention and modify their behavior.
References
Bjornstad, P., Drews, K. L., Caprio, S., Gubitosi-Klug, R., Nathan, D. M., Tesfaldet, B., Tryggestad, J., White, N. H., & Zeitler, P. (2021). Long-term complications in youth-onset type 2 diabetes. New England Journal of Medicine, 385(5), 416-426. Web.
Rasoul, A. M., Jalali, R., Abdi, A., Salari, N., Rahimi, M., & Mohammadi, M. (2019). The effect of self-management education through weblogs on the quality of life of diabetic patients. BMC Medical Informatics and Decision Making, 19(1), 1–13. Web.
Rusdiana, Savira, M., & Amelia, R. (2018). The effect of diabetes self-management education on Hba1c level and fasting blood sugar in type 2 diabetes mellitus patients in primary health care in Binjai City of North Sumatera, Indonesia. Open Access Macedonian Journal of Medical Sciences, 6(4), 715–718. Web.
Saltiel, A. R. (2001). New perspectives into the molecular pathogenesis and treatment of type 2 diabetes. Cell, 104(4), 517-529. Web.