Systematic meta-review of self-management support for people with type 2 diabetes

Abstract

Background: The aim was to provide a high-level overview of type 2 diabetes interventions that support self-management by carrying out a review of systematic reviews of Randomised Control Trials (RCTs) in 2012, plus an update in 2016. Methods: Seven electronic databases were searched plus snowball and manual searches (initial review searches up to 2012; update 2012-2016). Primary outcomes of interest were glycaemic control (e.g., HbA1c) and quality of life. Composition, delivery and setting of interventions were examined to identify the optimal configuration of self-management support. Findings: We included 17 systematic reviews in the initial review (published 2001 – 2012) incorporating 179 RCTs. The update found an additional 21 reviews. There is good evidence that self-management support improves glycaemic control in the short term and quality of life remains stable. Culturally tailored behaviour change support interventions delivered by health workers embedded within the community were similarly effective. Self-management support can be effectively delivered in a variety of ways across multiple countries with a range of professionals and lay people. Discussion: That quality of life remains unaltered in these interventions may be considered a positive outcome considering the potential for chronic illness to negatively impact on quality of life. The large number of reviews highlight that there is a range of delivery modes suited to support people with type 2 diabetes, the challenge is in tailoring services and resources to the individual at the right time (e.g., potentially when they are receptive to engage rather than when first diagnosed).