Self-Management Education for Adults With Type 2 Diabetes
Open accessAbstract
OBJECTIVE—To evaluate the efficacy of self-management education on GHb in adults with type 2 diabetes. RESEARCH DESIGN AND METHODS—We searched for English language trials in Medline (1980–1999), Cinahl (1982–1999), and the Educational Resources Information Center database (ERIC) (1980–1999), and we manually searched review articles, journals with highest topic relevance, and reference lists of included articles. Studies were included if they were randomized controlled trials that were published in the English language, tested the effect of self-management education on adults with type 2 diabetes, and reported extractable data on the effect of treatment on GHb. A total of 31 studies of 463 initially identified articles met selection criteria. We computed net change in GHb, stratified by follow-up interval, tested for trial heterogeneity, and calculated pooled effects sizes using random effects models. We examined the effect of baseline GHb, follow-up interval, and intervention characteristics on GHb. RESULTS—On average, the intervention decreased GHb by 0.76% (95% CI 0.34–1.18) more than the control group at immediate follow-up; by 0.26% (0.21% increase - 0.73% decrease) at 1–3 months of follow-up; and by 0.26% (0.05–0.48) at ≥4 months of follow-up. GHb decreased more with additional contact time between participant and educator; a decrease of 1% was noted for every additional 23.6 h (13.3–105.4) of contact. CONCLUSIONS—Self-management education improves GHb levels at immediate follow-up, and increased contact time increases the effect. The benefit declines 1–3 months after the intervention ceases, however, suggesting that learned behaviors change over time. Further research is needed to develop interventions effective in maintaining long-term glycemic control.
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There is clear evidence that diabetes education improves patient outcomes.
“However, there is clear evidence that diabetes education improves patient outcomes (97–99).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [99]
Clinical care management includes clinical assessment, medication management, self-management support, and care coordination, including among post-surgical cancer patients.
“Clinical care management, generally provided by a health care professional such as a nurse or clinical pharmacist, includes clinical assessment, medication management, self-management support, and care coordination28,39-44, including among post-surgical cancer patients14,15,45.”
From Self-management: Enabling and empowering patients living with cancer as a chronic illness (2011) · cites this paper as [39]
Chronically ill patients at higher risk of emergency room use, hospitalization, or major complications benefit from more intensive follow-up and clinical management by a care manager.
“Chronically ill patients at higher risk of emergency room use, hospitalization, or major complications have been shown to benefit from more intensive follow-up and clinical management by a care manager.”
From Self-management: Enabling and empowering patients living with cancer as a chronic illness (2011) · cites this paper as [39]
Self-management is crucial in daily disease management and to prevent macro- and microvascular complications.
“New treatments are evolving rapidly and self-management is crucial in daily disease management and to prevent macro- and microvascular complications [2,10,11].”
There is clear evidence that diabetes education improves patient outcomes.
“However, there is clear evidence that diabetes education improves patient outcomes (97 -99).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [99]
Self-management is an important and evidence-based component of treatment and care for patients with type 2 diabetes.
“Self-management is an important and evidence-based component of treatment and care for patients with type 2 diabetes [1] and [2]”
Diabetes self-management education and support is associated with lower A1C.
“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:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [17]
Diabetes self-management education and support is associated with improved diabetes knowledge and self-care behaviors.
“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:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [17]
Initial improvements in outcomes from DSMES have been shown to diminish 6 months after conclusion of the intervention.
“initial improvements in outcomes have been shown to diminish 6 months after conclusion of the intervention (80).”
From 2022 National standards for diabetes self-management education and support (2022) · cites this paper as [80]
Several studies have found that DSME is associated with improved diabetes knowledge and improved self-care behavior, improved clinical outcomes such as lower A1C, lower self-reported weight, and improved quality of life.
“Several studies have found that DSME is associated with improved diabetes knowledge and improved self-care behavior (101), improved clinical outcomes such as lower A1C (102,103,105,106,110), lower self-reported weight (101), and improved quality of life (104).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [102]
DSME is an essential element of diabetes care, and National Standards for DSME are based on evidence for its benefits.
“DSME is an essential element of diabetes care (100–106), and National Standards for DSME (107) are based on evidence for its benefits.”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [102]
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- Authors
- Norris, S. L., Lau, J., Smith, S. J., Schmid, C. H., & Engelgau, M. M.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Tufts University (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2002-07-01
- Volume
- 25
- Issue
- 7
- Pages
- 1159-1171
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2092783195
- Cited by
- 1,750
- References
- 80
- Citations by year
- 2026: 27 · 2025: 30 · 2024: 52 · 2023: 49 · 2022: 61 · 2021: 57 · 2020: 72 · 2019: 95 · 2018: 101 · 2017: 109 · 2016: 97 · 2015: 106 · 2014: 128 · 2013: 110 · 2012: 105
- FWCI
- 19.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- 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
- self-management education, type 2 diabetes, HbA1c, glycemic control, contact time, intervention duration
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Blood Glucose, Diabetes Mellitus, Type 2, Ethnicity, Health Personnel, Humans, Health Knowledge, Attitudes, Practice, Life Style, Middle Aged, Patient Education as Topic, Self Care, Randomized Controlled Trials as Topic, Databases, Factual
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 ›
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