Abstract
Background Type 2 diabetes mellitus (T2DM) accounts for approximately 95% of all diabetes cases, making the disease a global public health concern. The increasing prevalence of T2DM has highlighted the importance of evidence-based guidelines for effective prevention, management, and treatment. Diabetes self-management education (DSME) can produce positive effects on patient behaviors and health status. Study objective. We synthesized findings from the existing studies to find out whether or not the impact of DSME on patient health behaviors and outcomes differ by the different models of diabetes care. That is, we determined whether there are differences in DSME outcomes when patient's care provider is a general practitioner, a specialist, a nurse, or a combination of these health professionals. Methods Searches were made of six electronic databases to identify relevant English language publications on DSME from 2000 through 2019. Titles and abstracts of the search results were screened to select eligible papers for full-text screening. All eligible papers were retrieved, and full-text screening was done by three independent reviewers to select studies for inclusion in the final analysis. Twenty-one studies were included in the final analysis. The main outcome measures assessed were glycated hemoglobin (HbA1c), body mass index (BMI), diet, and physical activity. Results The majority of the patients with diabetes were seen by primary care physicians. In general, the studies reported significant improvements in patient health behaviors and outcomes. Some differences in outcomes between the different models of care were observed. Conclusion Our findings suggest that the effects of DSME on patients' health behaviors and outcomes could differ by the different models of diabetes care. However, considering the limited sample of publications reviewed, and because none of the reviewed studies directly measured the impact of the DSME program on patient behaviors and outcomes, significant conclusions could not be reached.
Highlights
Diabetes mellitus (DM) is one of the most common chronic disorders in the world [1]
We used a systematic scoping review, guided by the threestep search strategy recommended by the Joanna Briggs Institute [41] and the PRISMA statement for systematic reviews protocols [42], to gather and summarize the existing literature on the possible influence of the model of diabetes care on the outcomes of Diabetes self-management education (DSME) interventions
Other common exclusions included article not specifying the name of diabetes care provider (n = 41), focusing on either type 1 (n = 25), or both
Summary
Diabetes mellitus (DM) is one of the most common chronic disorders in the world [1]. It is the fifth leading cause of mortality in most high-income countries and rapidly becoming a major health concern in low- and middle-income countries [2]. The cost of diabetes care is expensive, and the condition can lead to serious complications such as kidney failure, Journal of Diabetes Research myocardial infarction, stroke, blindness, and limb amputation [6] It imposes a huge economic burden on national health care systems globally [1]. Diabetes self-management education (DSME) can produce positive effects on patient behaviors and health status. We synthesized findings from the existing studies to find out whether or not the impact of DSME on patient health behaviors and outcomes differ by the different models of diabetes care. Our findings suggest that the effects of DSME on patients’ health behaviors and outcomes could differ by the different models of diabetes care. Considering the limited sample of publications reviewed, and because none of the reviewed studies directly measured the impact of the DSME program on patient behaviors and outcomes, significant conclusions could not be reached
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