Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis
BackgroundDiabetes Self-Management Education (DSME) is a cornerstone strategy for improving glycemic control, yet its clinical effectiveness is often limited by suboptimal adherence. The aim of this study is to evaluate through meta-analysis the impact of nurse-led DSME on glycemic control, lipid pr...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-08-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1622988/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849242699656331264 |
|---|---|
| author | Jiabao Sun Zhenwei Fan Mengyuan Kou Xuewei Wang Zhongmin Yue Min Zhang |
| author_facet | Jiabao Sun Zhenwei Fan Mengyuan Kou Xuewei Wang Zhongmin Yue Min Zhang |
| author_sort | Jiabao Sun |
| collection | DOAJ |
| description | BackgroundDiabetes Self-Management Education (DSME) is a cornerstone strategy for improving glycemic control, yet its clinical effectiveness is often limited by suboptimal adherence. The aim of this study is to evaluate through meta-analysis the impact of nurse-led DSME on glycemic control, lipid profiles, and self-efficacy in adults with type 2 diabetes mellitus (T2DM).MethodsFollowing PRISMA 2020 guidelines, we systematically searched PubMed, EMBASE, and Web of Science databases (up to February 28, 2025). Inclusion criteria comprised: randomized controlled trials (RCTs) comparing nurse-led DSME (≥3 structured sessions) vs. usual care or other non-nurse-led interventions. Risk of bias was assessed using Cochrane RoB 2.0. Effect sizes [mean difference (MD) or standardized mean difference (SMD)] were pooled using R meta package with random-effects models (I2 > 50%). Subgroup analyses and meta-regression were performed.ResultsEight RCTs (reporting HbA1c outcomes) were included. Meta-analysis demonstrated: (1) Glycemic control: nurse-led DSME significantly reduced HbA1c at 4–6 months (MD = −0.92, 95% CI: −1.44 to −0.41) and >6 months (MD = −0.54, 95% CI: −0.86 to −0.23; p < 0.05), but not at 0–3 months (MD = −0.22, 95% CI: −1.15 to 0.51). Fasting blood glucose (FBG) showed significant improvement (MD = −0.20, 95% CI: −0.36 to −0.03). (2) Self-efficacy: the intervention group demonstrated significantly enhanced self-efficacy (SMD = 1.48, 95% CI: 1.04–1.92). (3) Lipid profiles: high-density lipoprotein (HDL) increased significantly (MD = 0.27, 95% CI: 0.14–0.41), while total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) showed no significant changes. (4) Considerable heterogeneity was observed (HbA1c: I2 = 87.8%; self-efficacy: I2 = 84.5%). Meta-regression suggested borderline significant influence of follow-up duration on effect size (p = 0.059). No significant publication bias was detected (Egger's test p = 0.116).ConclusionNurse-led DSME effectively improves long-term glycemic control and self-efficacy while elevating HDL levels in T2DM patients, though standardization of intervention protocols is needed to reduce heterogeneity. This study supports integrating nurse-led models into diabetes management guidelines and recommends future research focus on long-term follow-up and cost-effectiveness analyses.Systematic review registrationhttps://doi.org/10.37766/inplasy2025.7.0114, identifier: NPLASY202570114. |
| format | Article |
| id | doaj-art-cf63b0b5eba1472eb3289ee588a89d6a |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-cf63b0b5eba1472eb3289ee588a89d6a2025-08-20T03:59:45ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-08-011310.3389/fpubh.2025.16229881622988Impact of nurse-led self-management education on type 2 diabetes: a meta-analysisJiabao SunZhenwei FanMengyuan KouXuewei WangZhongmin YueMin ZhangBackgroundDiabetes Self-Management Education (DSME) is a cornerstone strategy for improving glycemic control, yet its clinical effectiveness is often limited by suboptimal adherence. The aim of this study is to evaluate through meta-analysis the impact of nurse-led DSME on glycemic control, lipid profiles, and self-efficacy in adults with type 2 diabetes mellitus (T2DM).MethodsFollowing PRISMA 2020 guidelines, we systematically searched PubMed, EMBASE, and Web of Science databases (up to February 28, 2025). Inclusion criteria comprised: randomized controlled trials (RCTs) comparing nurse-led DSME (≥3 structured sessions) vs. usual care or other non-nurse-led interventions. Risk of bias was assessed using Cochrane RoB 2.0. Effect sizes [mean difference (MD) or standardized mean difference (SMD)] were pooled using R meta package with random-effects models (I2 > 50%). Subgroup analyses and meta-regression were performed.ResultsEight RCTs (reporting HbA1c outcomes) were included. Meta-analysis demonstrated: (1) Glycemic control: nurse-led DSME significantly reduced HbA1c at 4–6 months (MD = −0.92, 95% CI: −1.44 to −0.41) and >6 months (MD = −0.54, 95% CI: −0.86 to −0.23; p < 0.05), but not at 0–3 months (MD = −0.22, 95% CI: −1.15 to 0.51). Fasting blood glucose (FBG) showed significant improvement (MD = −0.20, 95% CI: −0.36 to −0.03). (2) Self-efficacy: the intervention group demonstrated significantly enhanced self-efficacy (SMD = 1.48, 95% CI: 1.04–1.92). (3) Lipid profiles: high-density lipoprotein (HDL) increased significantly (MD = 0.27, 95% CI: 0.14–0.41), while total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) showed no significant changes. (4) Considerable heterogeneity was observed (HbA1c: I2 = 87.8%; self-efficacy: I2 = 84.5%). Meta-regression suggested borderline significant influence of follow-up duration on effect size (p = 0.059). No significant publication bias was detected (Egger's test p = 0.116).ConclusionNurse-led DSME effectively improves long-term glycemic control and self-efficacy while elevating HDL levels in T2DM patients, though standardization of intervention protocols is needed to reduce heterogeneity. This study supports integrating nurse-led models into diabetes management guidelines and recommends future research focus on long-term follow-up and cost-effectiveness analyses.Systematic review registrationhttps://doi.org/10.37766/inplasy2025.7.0114, identifier: NPLASY202570114.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1622988/fulltype 2 diabetes mellitusdiabetes self-management educationnurse-ledmeta-analysisself-efficacy |
| spellingShingle | Jiabao Sun Zhenwei Fan Mengyuan Kou Xuewei Wang Zhongmin Yue Min Zhang Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis Frontiers in Public Health type 2 diabetes mellitus diabetes self-management education nurse-led meta-analysis self-efficacy |
| title | Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis |
| title_full | Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis |
| title_fullStr | Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis |
| title_full_unstemmed | Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis |
| title_short | Impact of nurse-led self-management education on type 2 diabetes: a meta-analysis |
| title_sort | impact of nurse led self management education on type 2 diabetes a meta analysis |
| topic | type 2 diabetes mellitus diabetes self-management education nurse-led meta-analysis self-efficacy |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1622988/full |
| work_keys_str_mv | AT jiabaosun impactofnurseledselfmanagementeducationontype2diabetesametaanalysis AT zhenweifan impactofnurseledselfmanagementeducationontype2diabetesametaanalysis AT mengyuankou impactofnurseledselfmanagementeducationontype2diabetesametaanalysis AT xueweiwang impactofnurseledselfmanagementeducationontype2diabetesametaanalysis AT zhongminyue impactofnurseledselfmanagementeducationontype2diabetesametaanalysis AT minzhang impactofnurseledselfmanagementeducationontype2diabetesametaanalysis |