The Effect of Nurse-led Diabetes Self-management Education on Glycosylated Hemoglobin and Cardiovascular Risk Factors: A Meta-analysis
Abstract
PURPOSE: The purpose of this meta-analysis was to determine the effect of nurse-led diabetes self-management education (DSME) on blood glucose control and cardiovascular risk factors. METHODS: The electronic databases PubMed and ISIS Knowledge were searched for relevant randomized controlled studies published between 1999 and 2009. Effect size was calculated for change in A1C, blood pressure, and lipid levels using both fixed- and random-effects models. Subgroup analyses were performed on patient age, gender, diabetes type, baseline A1C, length of follow-up, and study setting. RESULTS: A total of 34 randomized controlled trials with a combined cohort size of 5993 patients was identified. Mean patient age was 52.8 years, 47% were male, and mean A1C at baseline was 8.5%. Mean change in A1C was a reduction by -0.70% for nurse-led DSME versus -0.21% with usual care (UC). This corresponded to an effect size of 0.506, using a random-effects model for nurse-led DSME versus UC. Effect size was significantly associated with patient age older than 65 years and with duration of follow-up. Nurse-led DSME was also associated with improvements in cardiovascular risk factors, particularly among male patients, among those with good glycemic control, and in studies conducted in the United States. CONCLUSIONS: Nurse-led DSME is associated with improved glycemic control, demonstrating that programs are most effective among seniors and with follow-up periods of 1 to 6 months. Future programs tailored to the needs of patients younger than 65 years may improve the impact of DSME on blood glucose.
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Diabetes care and education specialists, including nurses, registered dietitian nutritionists, and pharmacists, are providers of diabetes self-management education and support who may also tailor curriculum to the person's needs.
“Research supports diabetes care and education specialists (DCES), including nurses, registered dietitian nutritionists (RDNs), and pharmacists as providers of DSMES who may also tailor curriculum to the person's needs (68)(69)(70).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [69]
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- Authors
- Tshiananga, J. K. T., Kocher, S., Weber, C., Erny-Albrecht, K., Berndt, K., & Neeser, K.
- Affiliations
- Institute for Medical Informatics and Biostatistics (CH)
- Venue
- The Diabetes Educator
- Publisher
- SAGE Publications
- Published
- 2011-11-23
- Volume
- 38
- Issue
- 1
- Pages
- 108-123
- ISSN
- 0145-7217 (ISSN-L)
- 1554-6063
- OpenAlex
- W2141633549
- Cited by
- 209
- References
- 63
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 8 · 2023: 7 · 2022: 20 · 2021: 18 · 2020: 26 · 2019: 22 · 2018: 20 · 2017: 21 · 2016: 12 · 2015: 18 · 2014: 14 · 2013: 8
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Science of Diabetes Self-Management and Care (publishedVersion)
- PubMed (publishedVersion)
- 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, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes self-management education, nurse-led intervention, glycemic control, HbA1c, cardiovascular risk factors, blood pressure, serum lipids, older adults, patient age, follow-up duration, type 1 and type 2 diabetes
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Nurse Clinicians, Patient Education as Topic, Self Care, Biomarkers, Disease Management
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