The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: a systematic review and meta-analysis

• Published in: BMC health services research 2018-05, Vol.18 (1), p.367-367, Article 367
• Main Authors: Cunningham, Amy T, Crittendon, Denine R, White, Neva, Mills, Geoffrey D, Diaz, Victor, LaNoue, Marianna D
• Format: Article
• Language: English
• Subjects: African Americans; Black or African American; Business education; Cardiovascular disease; Comparative analysis; Cultural differences; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - therapy; Diabetes self-management education; Diabetes therapy; Disparities; Education; Evidence-based medicine; Exercise; Female; Glucose; Glucose monitoring; Glycated Hemoglobin - metabolism; Glycosylated hemoglobin; Health aspects; Health care; Health services; Hemoglobin; Hispanic Americans; Humans; Intervention; Male; Meta-analysis; Middle Aged; Minority & ethnic groups; Morbidity; Mortality; Nutrition research; Patient Education as Topic; Quality of Life; Quasi-experimental methods; Randomized Controlled Trials as Topic; Self-Management - education; Self-Management - methods; Systematic review; Type 2 diabetes; United States
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-018-3186-7

Type 2 diabetes presents a major morbidity and mortality burden in the United States. Diabetes self-management education (DSME) is an intervention associated with improved hemoglobin A1c(HbA1c) and quality of life(QOL), and is recommended for all individuals with type 2 diabetes. African-Americans have disproportionate type 2 diabetes morbidity and mortality, yet no prior meta-analyses have examined DSME outcomes exclusively in this population. This systematic review and meta-analysis examined the impact of DSME on HbA1c and QOL in African-Americans compared to usual care. Randomized controlled trials, cluster-randomized trials, and quasi-experimental interventions were included. 352 citations were retrieved; 279 abstracts were reviewed, and 44 full-text articles were reviewed. Fourteen studies were eligible for systematic review and 8 for HbA1c meta-analysis; QOL measures were too heterogeneous to pool. Heterogeneity of HbA1c findings was assessed with Cochran's Q and I . HbA1c weighted mean difference between intervention and usual care participants was not significant: - 0.08%[- 0.40-0.23];χ  = 84.79 (p