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Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis
Open accessAbstract
BACKGROUND: Diabetes self-management education (DSME) can be delivered in many forms. Group based DSME is widespread due to being a cheaper method and the added advantages of having patient meet and discuss with each other. assess effects of group-based DSME compared to routine treatment on clinical, lifestyle and psychosocial outcomes in type-2 diabetes patients. METHODS: A systematic review with meta-analysis. Computerised bibliographic database were searched up to January 2008 for randomised controlled trials evaluating group-based DSME for adult type-2 diabetics versus routine treatment where the intervention had at least one session and =/>6 months follow-up. At least two reviewers independently extracted data and assessed study quality. RESULTS: In total 21 studies (26 publications, 2833 participants) were included. Of all the participants 4 out of 10 were male, baseline age was 60 years, BMI 31.6, HbA1c 8.23%, diabetes duration 8 years and 82% used medication. For the main clinical outcomes, HbA1c was significantly reduced at 6 months (0.44% points; P=0.0006, 13 studies, 1883 participants), 12 months (0.46% points; P=0.001, 11 studies, 1503 participants) and 2 years (0.87% points; P<0.00001, 3 studies, 397 participants) and fasting blood glucose levels were also significantly reduced at 12 months (1.26 mmol/l; P<0.00001, 5 studies, 690 participants) but not at 6 months. For the main lifestyle outcomes, diabetes knowledge was improved significantly at 6 months (SMD 0.83; P=0.00001, 6 studies, 768 participants), 12 months (SMD 0.85; P<0.00001, 5 studies, 955 participants) and 2 years (SMD 1.59; P=0.03, 2 studies, 355 participants) and self-management skills also improved significantly at 6 months (SMD 0.55; P=0.01, 4 studies, 534 participants). For the main psychosocial outcomes, there were significant improvement for empowerment/self-efficacy (SMD 0.28, P=0.01, 2 studies, 326 participants) after 6 months. For quality of life no conclusion could be drawn due to high heterogeneity. For the secondary outcomes there were significant improvements in patient satisfaction and body weight at 12 months for the intervention group. There were no differences between the groups in mortality rate, body mass index, blood pressure and lipid profile. CONCLUSIONS: Group-based DSME in people with type 2 diabetes results in improvements in clinical, lifestyle and psychosocial outcomes.
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“For instance, diabetes education often uses group settings to reduce the pressure on health staff resources given the increasing numbers of people diagnosed with diabetes [4].”
From Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review (2018) · cites this paper as [4]
In the citing paper
“DSMES is associated with an increased use of primary care and preventive services (27,30,31) and less frequent use of acute care and inpatient hospital services (22).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023 (2023) · cites this paper as [22]
In the citing paper
“DSMES is associated with improved diabetes knowledge and self-care behaviors (17), lower A1C (17-21), lower selfreported weight (22), improved quality of life (19,23,24), reduced all-cause mortality risk (25), positive coping behaviors (5,26), and reduced health care costs (27)(28)(29).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023 (2023) · cites this paper as [22]
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Metadata
- Authors
- Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M. B., & Fretheim, A.
- Affiliations
- Norwegian University of Science and Technology (NO)
- University of Oslo (NO)
- Corresponding author
- Steinsbekk, Aslak
- Venue
- BMC Health Services Research
- Published
- 2012-07-23
- Volume
- 12
- Issue
- 1
- Pages
- 213-213
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC3418213
- OpenAlex
- W2025306913
- Cited by
- 660
- References
- 52
- Citations by year
- 2026: 23 · 2025: 28 · 2024: 28 · 2023: 46 · 2022: 48 · 2021: 52 · 2020: 71 · 2019: 67 · 2018: 59 · 2017: 63 · 2016: 56 · 2015: 53 · 2014: 43 · 2013: 21 · 2012: 1
- FWCI
- 5.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- BIBSYS Brage (BIBSYS (Norway)) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- Deakin University
- 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
- type 2 diabetes, HbA1c, glycemic control, fasting blood glucose, diabetes knowledge, self-management skills, psychosocial outcomes, patient education, cost-effectiveness, patient satisfaction, quality of life
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Diagnostic Tests, Routine, Female, Group Processes, Humans, Health Knowledge, Attitudes, Practice, Male, Patient Education as Topic, Power, Psychological, Quality of Life, Self Care, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care
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