A systematic review of interventions to improve diabetes care in socially disadvantaged populations
Open accessAbstract
OBJECTIVE—To identify and synthesize evidence about the effectiveness of patient, provider, and health system interventions to improve diabetes care among socially disadvantaged populations. RESEARCH DESIGN AND METHODS—Studies that were included targeted interventions toward socially disadvantaged adults with type 1 or type 2 diabetes; were conducted in industrialized countries; were measured outcomes of self-management, provider management, or clinical outcomes; and were randomized controlled trials, controlled trials, or before-and-after studies with a contemporaneous control group. Seven databases were searched for articles published in any language between January 1986 and December 2004. Twenty-six intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions. RESULTS—Eleven of 17 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included cultural tailoring of the intervention, community educators or lay people leading the intervention, one-on-one interventions with individualized assessment and reassessment, incorporating treatment algorithms, focusing on behavior-related tasks, providing feedback, and high-intensity interventions (>10 contact times) delivered over a long duration (≥6 months). Interventions that were consistently associated with the largest negative outcomes included those that used mainly didactic teaching or that focused only on diabetes knowledge. CONCLUSIONS—This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success. These types of interventions would require additional resources for needs assessment, leader training, community and family outreach, and follow-up.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A personalized educational approach leveraging a multidisciplinary team leads to greater self-management skills.
“A personalized educational approach to persons with DM, leveraging members of a multidisciplinary team, will lead to greater self-management skills.1459–1463”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1461]
The Analysis of features section (page unavailable) associates individualized assessment and behavioral approaches with more successful interventions for socially disadvantaged people with diabetes. The review also describes education delivered by different health care providers, but it does not establish that a multidisciplinary educational team leads specifically to greater self-management skills. Its findings are associations across varied outcomes, not the causal result stated here. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDiabetes self-management education and support interventions that were culturally appropriate were associated with better outcomes.
“Better outcomes were reported for DSMES interventions that were more than 10 h over the course of 6-12 months (20), included ongoing support (14,32), were culturally (33)(34)(35) and age appropriate (36,37), were tailored to individual needs and preferences, addressed psychosocial issues, and incorporated behavioral strategies (15,26,38,39).”
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 [34]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582 · see citing works
Audit and feedback: effects on professional practice and healthcare outcomes
Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., O'Brien, M. A., Johansen, M., Grimshaw, J., & Oxman, A. D. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000259.pub3 · Cited by 5,485 · see citing works
Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes
Gæde, P., Vedel, P., Larsen, N., Jensen, G. V. H., Parving, H.-H., & Pedersen, O. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021778 · Cited by 4,378 · see citing works
Kawamoto, K., Houlihan, C. A., Balas, E. A., & Lobach, D. F. (2005) · BMJ · doi:10.1136/bmj.38398.500764.8f · Cited by 2,703 · see citing works
Self-Management Education for Adults With Type 2 Diabetes
Norris, S. L., Lau, J., Smith, S. J., Schmid, C. H., & Engelgau, M. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.7.1159 · Cited by 1,750 · see citing works
Educational outreach visits: effects on professional practice and health care outcomes
O'Brien, M. A., Rogers, S., Jamtvedt, G., Oxman, A. D., Odgaard-Jensen, J., Kristoffersen, D. T., Forsetlund, L., Bainbridge, D., Freemantle, N., Davis, D., et al. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000409.pub2 · Cited by 1,279 · see citing works
Ethnic disparities in diabetic complications in an insured population
Karter, A. J. (2002) · JAMA · doi:10.1001/jama.287.19.2519 · Cited by 840 · see citing works
Karter, A. J., Ferrara, A. M., Darbinian, J. A., Ackerson, L., & Selby, J. V. (2000) · Diabetes Care · doi:10.2337/diacare.23.4.477 · Cited by 488 · see citing works
Culturally Competent Diabetes Self-Management Education for Mexican Americans
Brown, S. A., García, A. A., Kouzekanani, K., & Hanis, C. L. (2002) · Diabetes Care · doi:10.2337/diacare.25.2.259 · Cited by 437 · see citing works
Rothman, R. L. (2004) · JAMA · doi:10.1001/jama.292.14.1711 · Cited by 395 · see citing works
Agurs‐Collins, T., Kumanyika, S., Have, T. R. T., & Adams-Campbell, L. L. (1997) · Diabetes Care · doi:10.2337/diacare.20.10.1503 · Cited by 347 · see citing works
O’Brien, M. A., Freemantle, N., Oxman, A. D., Wolfe, F., Davis, D., & Herrin, J. S. (2001) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003030 · Cited by 340 · see citing works
Audit and feedback: effects on professional practice and health care outcomes
Jamtvedt, G., Young, J. G., Kristoffersen, D., O'Brien, M., & Oxman, A. D. (2003) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000259 · Cited by 285 · see citing works
Multiple hospitalizations for patients with diabetes
Jiang, H. J., Stryer, D., Friedman, B., & Andrews, R. (2003) · Diabetes Care · doi:10.2337/diacare.26.5.1421 · Cited by 261 · see citing works
Keyserling, T. C., Samuel-Hodge, C. D., Ammerman, A. S., Ainsworth, B. E., Henríquez-Roldán, C. F., Elasy, T. A., Skelly, A. H., Johnston, L. F., & Bangdiwala, S. I. (2002) · Diabetes Care · doi:10.2337/diacare.25.9.1576 · Cited by 255 · see citing works
Gary‐Webb, T. L., Bone, L., Hill, M. N., Levine, D. M., McGuire, M., Saudek, C. D., & Brancati, F. L. (2003) · Preventive Medicine · doi:10.1016/s0091-7435(03)00040-9 · Cited by 226 · see citing works
Relationship Between Avoidable Hospitalizations for Diabetes Mellitus and Income Level
Booth, G. L., & Hux, J. E. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.1.101 · Cited by 223 · see citing works
Lexchin, J., & Grootendorst, P. V. (2004) · International Journal of Health Services · doi:10.2190/4m3e-l0yf-w1td-ekg0 · Cited by 199 · see citing works
Interventions to Promote Diabetes Self-Management: State of the Science
Brown, S. A. (1999) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572179902500623 · Cited by 181 · see citing works
Local opinion leaders: effects on professional practice and health care outcomes
O'Brien, M., Oxman, A. D., Haynes, R. B., Davis, D. A., Freemantle, N., & Harvey, E. (1999) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000125 · Cited by 159 · see citing works
Arblaster, L., Lambert, M., Entwistle, V., Forster, M., Fullerton, D., Sheldon, T., & Watt, I. (1996) · Journal of Health Services Research and Policy · doi:10.1177/135581969600100207 · Cited by 150 · see citing works
Culturally Competent Diabetes Education for Mexican Americans: The Starr County Study
Brown, S. A., & Hanis, C. L. (1999) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572179902500208 · Cited by 148 · see citing works
Rapid A1c Availability Improves Clinical Decision-Making in an Urban Primary Care Clinic
Miller, C. D., Barnes, C. S., Phillips, L. S., Ziemer, D. C., Gallina, D. L., Cook, C. B., Maryman, S. D., & El‐Kebbi, I. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.4.1158 · Cited by 144 · see citing works
Eakin, E., Bull, S. S., Glasgow, R. E., & Mason, M. A. (2002) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.266 · Cited by 140 · see citing works
Effect of a Pharmacist-Managed Diabetes Care Program in a Free Medical Clinic
Davidson, M. B., Karlan, V. J., & Hair, T. L. (2000) · American Journal of Medical Quality · doi:10.1177/106286060001500403 · Cited by 109 · see citing works
Effect of Nurse-Directed Diabetes Care in a Minority Population
Davidson, M. B. (2003) · Diabetes Care · doi:10.2337/diacare.26.8.2281 · Cited by 101 · see citing works
Basch, C. E., Walker, E. A., Howard, C. J., Shamoon, H., & ZYBERT, P. A. (1999) · American Journal of Public Health · doi:10.2105/ajph.89.12.1878 · Cited by 95 · see citing works
The California Medi-Cal Type 2 Diabetes Study Group (2004) · Diabetes Care · doi:10.2337/diacare.27.1.95 · Cited by 92 · see citing works
A Diabetes Management Program for African American Women With Type 2 Diabetes
Keyserllng, T. C., Ammerman, A., Samuel-Hodge, C., Ingram, A. F., Skelly, A., Elasy, T., Johnston, L. F., Cole, A. S., & Henriquez-Rolddn, C. F. (2000) · The diabetes educator · doi:10.1177/014572170002600508 · Cited by 67 · see citing works
Clancy, D. E., Brown, S., Magruder, K. M., & Huang, P. (2003) · PubMed · Cited by 64 · see citing works
Community-Based Exercise Intervention: Zuni Diabetes Project
Heath, G. W., Leonard, B. E., Wilson, R. H., et al. (1987) · Diabetes Care · doi:10.2337/diacare.10.5.579 · Cited by 51 · see citing works
Evaluation of an audiovisual diabetes education program
Mulrow, C. D., Bailey, S., Sönksen, P. H., & Slavin, B. (1987) · Journal of General Internal Medicine · doi:10.1007/bf02596442 · Cited by 50 · see citing works
A taxonomy for diabetes educational interventions
Elasy, T. A., Ellis, S. E., Brown, A. W., & Pichert, J. W. (2001) · Patient Education and Counseling · doi:10.1016/s0738-3991(00)00150-6 · Cited by 48 · see citing works
Bazargan, M., Johnson, K. H., & Stein, J. A. (2003) · PubMed · Cited by 46 · see citing works
Elshaw, E. B., YOUNG, E. A., Saunders, M. J., McGurn, W. C., & López, L. C. (1994) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572179402000309 · Cited by 43 · see citing works
Improving Efficacy of Diabetes Management Using Treatment Algorithms in a Mainly Hispanic Population
Fanning, E. L., Selwyn, B. J., Larme, A. C., & DeFronzo, R. A. (2004) · Diabetes Care · doi:10.2337/diacare.27.7.1638 · Cited by 35 · see citing works
Chapin, R. B., Williams, D. C., & Adair, R. F. (2003) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2003.20367.x · Cited by 32 · see citing works
Ethnic differences in diabetes care in a multiethnic community in New Zealand
Simmons, D. S., Gatland, B. A., Leakehe, L., et al. (1996) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(96)90014-5 · Cited by 21 · see citing works
Echeverry, D., Dike, M. R., Washington, C., et al. (2003) · PubMed · Cited by 12 · see citing works
The effect of case management on glycemic control in patients with type 2 diabetes
Middleton, J. (2003) · The Case Manager · doi:10.1016/j.casemgr.2003.09.007 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Standards of medical care in diabetes—2014
American Diabetes Association (2014) · Diabetes Care · doi:10.2337/dc14-s014 · Cited by 4,572 · see citing works
Standards of medical care in diabetes—2013
American Diabetes Association (2013) · Diabetes Care · doi:10.2337/dc13-s011 · Cited by 4,369 · see citing works
Standards of medical care in diabetes 2010
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc10-s011 · Cited by 3,470 · see citing works
Standards of medical care in diabetes—2011
American Diabetes Association (2011) · Diabetes Care · doi:10.2337/dc11-s011 · Cited by 2,880 · see citing works
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.003 · Cited by 914 · see citing works
5. Lifestyle Management:<i>Standards of Medical Care in Diabetes—2019</i>
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc19-s005 · Cited by 700 · see citing works
4. Lifestyle Management: <i>Standards of Medical Care in Diabetes—2018</i>
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dc18-s004 · Cited by 563 · see citing works
Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507 · see citing works
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s005 · Cited by 362 · see citing works
2017 national standards for diabetes self-management education and support
Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E., Cypress, M., Faulkner, P., Fischl, A. H., Francis, T., et al. (2017) · Diabetes Care · doi:10.2337/dci17-0025 · Cited by 348 · see citing works
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s005 · Cited by 445 · see citing works
Ryan, R. E., Santesso, N., Lowe, D., Hill, S., Grimshaw, J. M., Prictor, M., Kaufman, C., Cowie, G., & Taylor, M. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007768.pub3 · Cited by 273 · see citing works
American Diabetes Association (2017) · Diabetes Care · doi:10.2337/dc17-s007 · Cited by 281 · see citing works
National Standards for Diabetes Self-Management Education and Support
Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., Fisher, E. B., Hanson, L., Kent, D., Kolb, L., et al. (2014) · Diabetes Care · doi:10.2337/dc14-s144 · Cited by 264 · see citing works
Behavioral and Psychosocial Interventions in Diabetes
Peyrot, M., & Rubin, R. R. (2007) · Diabetes Care · doi:10.2337/dc07-1222 · Cited by 247 · see citing works
Behavioral Programs for Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis
Pillay, J., Armstrong, M. J., Butalia, S., Donovan, L. E., Sigal, R. J., Vandermeer, B., Chordiya, P., Dhakal, S., Hartling, L., Nuspl, M., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-1400 · Cited by 223 · see citing works
Lee, S. W. H., Chan, C. K. Y., Chua, S. S., & Chaiyakunapruk, N. (2017) · Scientific Reports · doi:10.1038/s41598-017-12987-z · Cited by 200 · see citing works
2022 National standards for diabetes self-management education and support
Davis, J., Fischl, A. H., Beck, J., Browning, L., Carter, A., Condon, J. E., Dennison, M., Francis, T., Hughes, P. J., Jaime, S., et al. (2022) · Diabetes Care · doi:10.2337/dc21-2396 · Cited by 191 · see citing works
Nutritionist Visits, Diabetes Classes, and Hospitalization Rates and Charges
Robbins, J. M., Thatcher, G. E., Webb, D. A., & Valdmanis, V. G. (2008) · Diabetes Care · doi:10.2337/dc07-1871 · Cited by 183 · see citing works
2022 National standards for diabetes self-management education and support
Davis, J., Fischl, A. H., Beck, J., Browning, L., Carter, A., Condon, J. E., Dennison, M., Francis, T., Hughes, P. J., Jaime, S., et al. (2022) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106211072203 · Cited by 169 · see citing works
Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V. (2020) · Primary Care Diabetes · doi:10.1016/j.pcd.2019.08.009 · Cited by 144 · see citing works
Worswick, J., Wayne, S. C., Bennett, R., Fiander, M., Mayhew, A., Weir, M. C., Sullivan, K. J., & Grimshaw, J. M. (2013) · Systematic Reviews · doi:10.1186/2046-4053-2-26 · Cited by 130 · see citing works
Creamer, J., Attridge, M., Ramsden, M., Cannings‐John, R., & Hawthorne, K. (2016) · Diabetic Medicine · doi:10.1111/dme.12865 · Cited by 109 · see citing works
Murphy, M. E., Byrne, M., Galvin, R., Boland, F., Fahey, T., & Smith, S. M. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-015135 · Cited by 94 · see citing works
Houle, J., Beaulieu, M. ‐., Chiasson, J. ‐., Lespérance, F., Côté, J., Strychar, I., Bherer, L., Meunier, S., & Lambert, J. (2015) · Diabetic Medicine · doi:10.1111/dme.12686 · Cited by 92 · see citing works
Optimizing diabetes control in people with type 2 diabetes through nurse-led telecoaching
Odnoletkova, I., Goderis, G., Nobels, F., Fieuws, S., Aertgeerts, B., Annemans, L., & Ramaekers, D. (2016) · Diabetic Medicine · doi:10.1111/dme.13092 · Cited by 78 · see citing works
Anderson, A., O’Connell, S. S., Thomas, C., & Chimmanamada, R. (2022) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01174-6 · Cited by 70 · see citing works
“Therefore, we categorized telehealth interventions based on the intended target for improving glycemic control [25].”
MethodBlickem, C., Kennedy, A., Vassilev, I., Morris, R., Brooks, H., Jariwala, P., Blakeman, T., & Rogers, A. (2013) · Health Expectations · doi:10.1111/hex.12088 · Cited by 65 · see citing works
Anderson, D. R., Christison-Lagay, J., Villagra, V., Liu, H., & Dziura, J. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1419-5 · Cited by 64 · see citing works
Karran, E. L., Grant, A. R., Lee, H., Kamper, S. J., Williams, C. M., Wiles, L. K., Shala, R., Poddar, C. V., Astill, T., & Moseley, G. L. (2023) · BMC Public Health · doi:10.1186/s12889-023-15329-z · Cited by 39 · see citing works
Yang, Q., Hatch, D., Crowley, M. J., Lewinski, A. A., Vaughn, J., Steinberg, D., Vorderstrasse, A., Jiang, M., & Shaw, R. J. (2020) · JMIR mHealth and uHealth · doi:10.2196/17730 · Cited by 30 · see citing works
Lu, J. B., Danko, K. J., Elfassy, M. D., Welch, V., Grimshaw, J. M., & Ivers, N. M. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018826 · Cited by 34 · see citing works
- Authors
- Glazier, R. H., Bajcar, J., Kennie, N. R., & Willson, K.
- Affiliations
- St. Michael's Hospital (CA)
- Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
- University of Toronto (CA)
- ORCID
- Glazier, Richard H.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-07-01
- Volume
- 29
- Issue
- 7
- Pages
- 1675-1688
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2123708941
- Cited by
- 385
- References
- 41
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 11 · 2023: 14 · 2022: 27 · 2021: 30 · 2020: 16 · 2019: 18 · 2018: 16 · 2017: 29 · 2016: 21 · 2015: 25 · 2014: 28 · 2013: 39 · 2012: 20
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Ministry of Health and Long-Term Care
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- disadvantaged groups, type 1 diabetes, type 2 diabetes, diabetes self-management, health interventions, cultural tailoring, community health workers, individualized care, treatment algorithm, feedback, intervention intensity, health disparities
- MeSH terms
- Adult, Diabetes Mellitus, Humans, Patient Care Management, Patient Education as Topic, Psychosocial Deprivation, Randomized Controlled Trials as Topic, Patient-Centered Care, Developed Countries, Vulnerable Populations
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
