Effect of diabetes self-management education (DSME) on glycated hemoglobin (HbA1c) level among patients with T2DM: Systematic review and meta-analysis of randomized controlled trials
Abstract
Background and aims Type 2 Diabetes mellitus (T2DM) has been a global public health issue causing in physical, financial and psychosocial crises. The aim of this systematic review and meta-analysis (SRMA) was to evaluate the Diabetes Self-Management Education or Support (DSME/S) on glycosylated hemoglobin (HbA1c) among T2DM patients. Methods This SRMA was made according to preferred reporting Items for systematic review and Meta-analysis (PRISMA) guidelines. The relevant articles were searched from four databases: Cochrane Library, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Quality assessment was carried out. Pooled standard mean difference in HbA1c were calculated to obtain the effect size with random effect assumption. Subgroup analysis was conducted for assessing heterogeneity among the studies. Results A total of 1312 studies were identified from databases. Among these 25 studies met inclusion criteria. From these 20 were included in the meta-analysis. In meta-analysis a pooled standard mean difference in HbA1c was -0.604 (95% confidence interval = -0.854 -0.353, I 2 = 90.3, p Conclusion However, there is paucity of studies in underdeveloped countries. Therefore, further studies validated to these contexts are needed to evaluate the DSME effectiveness. Trial registration PROSPERO database CRD42020124236.
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Diabetes self-management education and support compared with usual care reported a pooled HbA1C difference of −0.60% (95% CI, −0.85% to −0.35%).
“A meta-analysis of 20 randomized clinical trials comparing diabetes self-management education and support with usual care reported a pooled HbA1C difference of −0.60% (95% CI, −0.85% to −0.35%).32”
From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [32]
In meta-analyses of people with diabetes (type 1 and 2), clinically meaningful HbA1C reductions have been reported for Mediterranean-style vs control diets (difference in HbA1C, −0.39% [95% CI, −0.58% to −0.20%]), the Dietary Approaches to Stop Hypertension vs control diets (difference in HbA1C, −0.53% [95% CI, −0.62% to −0.43%]), and low- vs high-carbohydrate diets (difference in HbA1C at 6 mo, −
“In meta-analyses of people with diabetes (type 1 and 2), clinically meaningful HbA1C reductions have been reported for Mediterranean-style vs control diets (difference in HbA1C, −0.39% [95% CI, −0.58% to −0.20%]), the Dietary Approaches to Stop Hypertension vs control diets (difference in HbA1C, −0.53% [95% CI, −0.62% to −0.43%]), and low- vs high-carbohydrate diets (difference in HbA1C at 6 mo, −”
From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [26]
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References 68 · Cited by 82
- Authors
- Bekele, B. B., Negash, S., Bogale, B., Tesfaye, M., Getachew, D., Weldekidan, F., & Balcha, B.
- Affiliations
- University of Debrecen (HU)
- Mizan Tepi University (ET)
- Wolaita Sodo University (ET)
- Corresponding author
- Bekele, Bayu Begashaw
- Venue
- Diabetes & Metabolic Syndrome: Clinical Research & Reviews
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 15
- Issue
- 1
- Pages
- 177-185
- ISSN
- 1871-4021 (ISSN-L)
- OpenAlex
- W3115466688
- Cited by
- 82
- References
- 68
- Citations by year
- 2026: 19 · 2025: 24 · 2024: 13 · 2023: 12 · 2022: 8 · 2021: 6
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes & Metabolic Syndrome Clinical Research & Reviews (publishedVersion)
- PubMed (publishedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetes self-management education, HbA1c, type 2 diabetes, glycemic control, diabetes self-management support, low- and middle-income countries
- MeSH terms
- Self-Management, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Randomized Controlled Trials as Topic
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