Interventions for self-management of type 2 diabetes: An integrative review
Open accessAbstract
BACKGROUND: Type 2 diabetes mellitus has been identified as one of the most challenging chronic illnesses to manage. Since the management of diabetes is mainly accomplished by patients and families, self-management has become the mainstay of diabetes care. However, a significant proportion of patients fail to engage in adequate self-management. A priority research question is how do interventions affect the self-management behaviors of persons with Type 2 diabetes? PURPOSE/OBJECTIVES: The purpose of this integrative review is to provide a summary and critique of interventions that support diabetes self-management in the patient with Type II diabetes mellitus. DESIGN: An integrative review design, with a comprehensive methodological approach of reviews, allowing inclusion of experimental and non-experimental studies. PROCEDURES: A comprehensive search was conducted via Ebscohost using databases of Academic Search Complete, CINAHL, Health Source: Nursing/Academic Edition, MEDLINE, PsycArtiCLES, and PsycInfo. The final number of papers used for this review were: motivational interviewing (6), peer support/coaching (10), problem solving therapy (3), technology-based interventions (30), lifestyle modification programs (7), patient education (11), mindfulness (3), and cognitive behavioral therapy (5). RESULTS: Studies were examined from seventeen countries including a broad range of cultures and ethnicities. While interventions have shown mixed results in all interventional categories, many studies do support small to modest improvements in physiologic, behavioral, and psychological outcome measures. Considerable heterogeneity of interventions exists. The most commonly reported physiologic measure was HbA1c level. Outcome measures were collected mostly at 6 and 12 months. Duration of most research was limited to one year. CONCLUSIONS: Research exploring the impact of interventions for self-management has made major contributions to the care of persons with type 2 diabetes, from offering suggestions for improving care, to stimulating new questions for research. However, implications for clinical practice remain inconclusive, and limitations in existing research suggest caution in interpreting results of studies.
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Diabetes is directly influenced by various lifestyle factors, and lifestyle modifications are the cornerstones of nonpharmacological management of T2DM.
“Given that diabetes is directly influenced by various lifestyle factors, lifestyle modifications, including dietary changes, weight management, increased physical activity, smoking cessation, and psychological support, are the cornerstones of nonpharmacological management of the condition [4,6-10].”
From Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial (2025) · cites this paper as [6]
The Discussion (Outcome measures; page unavailable) calls diet and physical activity two major cornerstones of diabetes self-management. The Results (Intervention categories; page unavailable) also describes programs addressing weight, smoking cessation, stress, and social support. It does not establish that every listed modification is a cornerstone of nonpharmacological management or that diabetes itself is directly influenced by each one. (LLM, conf=0.84)
Experimental — accuracy not yet measuredDaily self-management imposes a significant burden on patients with T2DM, often leading to increased emotional distress and feelings of being overwhelmed.
“However, the demanding character of daily self-management imposes a significant burden on patients with T2DM. Adopting new healthier habits, along with the need for constant blood glucose monitoring and medication adherence, often leads to increased emotional distress and feelings of being overwhelmed [6,11-13].”
From Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial (2025) · cites this paper as [6]
In order to gain valuable information for therapy optimization, people with diabetes must be educated adequately, their skills re-evaluated regularly, and SMBG measurements and associated diabetes management carried out frequently, consistently, and in a structured manner.
“In order to gain valuable information for therapy optimization, PwD do not only have to be educated adequately and their skills re-evaluated on a regular basis, but SMBG measurements and the associated diabetes management have to be carried out frequently, consistently, and in a structured manner [32].”
From Self-Monitoring of Blood Glucose as an Integral Part in the Management of People with Type 2 Diabetes Mellitus (2022) · cites this paper as [32]
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References 152 · Cited by 170
Research works printed but not linked: 2
- [6]American Diabetes Association Joint statement outlines guidance on diabetes self-management education, support 2015 Retrieved from http://www.diabetes.org/newsroom/press-releases/2015/joint-statement-outlines-guidance-on-diabetes-self-management-education-support.html#sthash.c6F6H8Qc.dpuf
- [17]Miller W.R. Rollnick S.R. Motivational interviewing: preparing people to change behavior 1991 Guilford Press New York
- Authors
- Carpenter, R., DiChiacchio, T., & Barker, K.
- Affiliations
- West Virginia University (US)
- Corresponding author
- Carpenter, Roger
- Venue
- International Journal of Nursing Sciences
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 6
- Issue
- 1
- Pages
- 70-91
- ISSN
- 2096-6296 (ISSN-L)
- 2352-0132
- PMC
- PMC6608673
- OpenAlex
- W2905253893
- Cited by
- 170
- References
- 152
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 24 · 2023: 31 · 2022: 29 · 2021: 25 · 2020: 24 · 2019: 4
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- International Journal of Nursing Sciences (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- The Research Repository @ WVU (West Virginia University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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 › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- type 2 diabetes, diabetes self-management, self-management interventions, motivational interviewing, problem-solving therapy, technology-based interventions, lifestyle modification program, patient education, mindfulness, cognitive behavioral therapy, HbA1c, glycemic control
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