The Effects of Diabetes Self-Management Education and Support Program in Thailand: A Systematic Review and Meta-Analysis

Abstract

Background: Diabetes is a growing health problem worldwide. Diabetes self-management education and support (DSMES) program is a crucial component in promoting self-care in all people with diabetes. However, the practice in certain countries, including Thailand, is not yet standardized, thus the effectiveness of such program is unknown. Objective: To evaluate the effectiveness of DSMES in Thailand. The outcomes were glycemic control, lipid levels, body mass index (BMI), quality of life (QoL), and diabetes knowledge. Materials and Methods: The authors searched PubMed, Scopus, and ProQuest databases since their inception until March 2019 for randomized controlled trials conducted in Thailand that evaluated outcomes of DSMES programs. Meta-analyses were performed to pool mean differences (MD) of the outcomes. Results: Seven studies, with 1,523 participants, were included. DSMES programs were conducted in different healthcare settings by health professionals from multiple disciplines. The results revealed that participants receiving DSMES had significantly lower hemoglobin A1c, MD –0.66% (95% CI –0.90 to –0.42), and FBG levels, MD –15.88 mg/dL (95% CI –20.95 to –10.79), than those who did not. Lipid levels, BMI, QoL, and diabetes knowledge, however, did not significantly differ. Conclusion: Meta-analysis results showed that DSEMS is effective in improving glycemic control and should be promoted to combat the burden of this important health problem in Thailand. Keywords: Diabetes self-management education and support; DSMES; Glycemic control; Meta-analysis; Thailand