Policy, Planning, Monitoring, & Evaluation Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Laboratory Services Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
J Diabetes Res. 2021 Feb 19;2021:2969243. doi: 10.1155/2021/2969243. eCollection 2021.
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. . 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.
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.
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.
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.
2 型糖尿病（T2DM）约占所有糖尿病病例的 95%，使该疾病成为全球公共卫生关注的焦点。T2DM 的患病率不断上升，突显了制定基于证据的指南以进行有效预防、管理和治疗的重要性。糖尿病自我管理教育（DSME）可以对患者的行为和健康状况产生积极影响。我们综合了现有研究的结果，以确定 DSME 对患者健康行为和结果的影响是否因不同的糖尿病护理模式而有所不同。也就是说，我们确定了当患者的护理提供者是全科医生、专科医生、护士还是这些卫生专业人员的组合时，DSME 结果是否存在差异。
在六个电子数据库中进行了检索，以查找 2000 年至 2019 年间关于 DSME 的相关英文文献。筛选检索结果的标题和摘要，以选择进行全文筛选的合格论文。检索到所有合格论文，并由三名独立评审员进行全文筛选，以选择纳入最终分析的研究。最终分析包括 21 项研究。评估的主要结果测量指标是糖化血红蛋白（HbA1c）、体重指数（BMI）、饮食和体育活动。
大多数糖尿病患者由初级保健医生就诊。总体而言，这些研究报告了患者健康行为和结果的显著改善。观察到不同护理模式之间的结果存在一些差异。
我们的研究结果表明，DSME 对患者健康行为和结果的影响可能因不同的糖尿病护理模式而有所不同。然而，考虑到所审查的出版物样本有限，并且由于所审查的研究均未直接测量 DSME 计划对患者行为和结果的影响，因此无法得出重大结论。
