University of Kentucky College of Nursing, Lexington, Kentucky.
Sci Diabetes Self Manag Care. 2024 Feb;50(1):87-95. doi: 10.1177/26350106231213400. Epub 2023 Nov 23.
The purpose of this systematic review was to examine the impact of diabetes self-management education (DSME) programs on A1C levels of Black/African American adults with type 2 diabetes.
Authors followed PRISMA guidelines and searched PubMed and CINAHL databases to identify articles published from 2000 to date. The primary outcome was A1C and participation in a DSME program among Black/African Americans with diabetes.
Nine high-quality randomized control trials (RCTs) were included in this review. Sample sizes ranged between 48 and 211. Studies reported Black/African American samples ranging from 23% to 57% (n = 4), 4 reported 100%, and 1 reported 96%. Most (56%) reported a statistically significant decline in A1C levels postprogram, whereas 44% noted insignificant changes. All the studies compared the DSME intervention effect to a control group or another type of diabetes self-management program.
The results suggest that DSME programs can be effective at lowering A1C levels in Black/African American adults; however, more research with larger sample sizes of Black/African Americans is warranted. The availability of meta-analyses and more RCTs could also further strengthen the external validity of this review. Additionally, future studies focused on A1C outcomes within DSME programs not combined with other self-management interventions among Black/African Americans can advance science regarding the impact of DSME programs among this disparate population.
本系统评价旨在研究糖尿病自我管理教育（DSME）计划对黑人/非裔美国成年 2 型糖尿病患者 A1C 水平的影响。
作者遵循 PRISMA 指南，检索了 PubMed 和 CINAHL 数据库，以确定从 2000 年至今发表的文章。主要结果是 A1C 和参与糖尿病黑人/非裔美国人的 DSME 计划。
本综述纳入了 9 项高质量的随机对照试验（RCT）。样本量范围在 48 到 211 之间。研究报告的黑人/非裔美国人样本比例在 23%到 57%之间（n=4），4 项研究报告为 100%，1 项研究报告为 96%。大多数（56%）研究报告表明，方案后 A1C 水平有统计学意义的下降，而 44%的研究则没有显著变化。所有研究都将 DSME 干预效果与对照组或另一种糖尿病自我管理方案进行了比较。
结果表明，DSME 方案可以有效降低黑人/非裔美国成年人的 A1C 水平；然而，需要更多的研究来扩大黑人/非裔美国人的样本量。荟萃分析和更多 RCT 的出现也可以进一步提高本综述的外部有效性。此外，未来专注于黑人/非裔美国人中不与其他自我管理干预措施结合的 DSME 方案内 A1C 结果的研究可以推进关于 DSME 方案对这一不同人群影响的科学研究。
