Mohamed Arbaktun, Staite Emily, Ismail Khalida, Winkley Kirsty
Department of Psychological Medicine Institute of Psychiatry, Psychology and Neuroscience King's College London London UK.
Florence Nightingale Faculty of Nursing Midwifery & Palliative Care King's College London London UK.
Nurs Open. 2019 Sep 3;6(4):1424-1437. doi: 10.1002/nop2.340. eCollection 2019 Oct.
To assess the effectiveness of educational and/or psychological diabetes self-management education (DSME) intervention for people with type 2 diabetes (T2DM) in the Asian Western Pacific (AWP) region.
Translational research indicates that DSME is effective; therefore, it is important to look at the AWP region to see what has been implemented and what the potential barriers are for the low integration of DSME. The need for DSME is present, and programmes are being developed. Therefore, focusing a systematic review of DSME research in the AWP region would give a better understanding of which intervention approaches are associated with better clinical outcomes and are culturally acceptable.
A systematic review.
A review of randomized controlled trials (RCTs) and comparative studies to evaluate the effectiveness of face-to-face delivery reporting educational and/or psychological interventions for people with T2DM was implemented. We conducted searches using MEDLINE, EMBASE, CINAHL, PubMed and ASSIA databases between January 1990-June 2018. Studies published in English and non-English were included. Two reviewers independently extracted data on participant and intervention characteristics. The quality of evidence was rated on predetermined criteria. Main outcomes included glycaemic control (reduction in HbA1c level).
We included 21 DSME programmes (17 RCTs), while 15 were group-based approaches. Twelve studies (60%) were categorized as high quality. Three studies (25%) had a moderate (good) effect. Eight trials were effective in improving glycaemic control and reported statistically significant improvements in HbA1c levels. 50% of these were high-intensity group-based programmes.
评估教育和/或心理糖尿病自我管理教育（DSME）干预措施对亚太地区2型糖尿病（T2DM）患者的有效性。
转化研究表明DSME是有效的；因此，考察亚太地区以了解DSME的实施情况以及其低整合度的潜在障碍很重要。对DSME的需求是存在的，相关项目也在不断发展。因此，对亚太地区DSME研究进行系统综述将有助于更好地理解哪些干预方法能带来更好的临床效果且在文化上是可接受的。
系统综述。
对随机对照试验（RCT）和比较研究进行综述，以评估针对T2DM患者的面对面教育和/或心理干预措施的有效性。我们在1990年1月至2018年6月期间使用MEDLINE、EMBASE、CINAHL、PubMed和ASSIA数据库进行检索。纳入了以英文和非英文发表的研究。两名评审员独立提取关于参与者和干预特征的数据。根据预定标准对证据质量进行评级。主要结局包括血糖控制（糖化血红蛋白水平降低）。
我们纳入了21个DSME项目（17项RCT），其中15个是基于小组的方法。12项研究（60%）被归类为高质量。3项研究（25%）有中度（良好）效果。8项试验在改善血糖控制方面有效，并报告糖化血红蛋白水平有统计学上的显著改善。其中50%是高强度的基于小组的项目。
