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. 2025 Jun 3:6:1554524.
doi: 10.3389/fcdhc.2025.1554524. eCollection 2025.

Effectiveness of diabetes self-management education and support interventions on glycemic levels among people living with type 2 diabetes in the WHO African Region: a Systematic Review and meta-analysis

Yimer Seid Yimer  1 , Adamu Addissie  1 , Eshetu Girma Kidane  2 , Ahmed Reja  3 , Abdurezak Ahmed Abdela  3 , Ahmed Ali Ahmed  1
Affiliations

Effectiveness of diabetes self-management education and support interventions on glycemic levels among people living with type 2 diabetes in the WHO African Region: a Systematic Review and meta-analysis

Yimer Seid Yimer et al. Front Clin Diabetes Healthc. .

Abstract

Background: For successful glycemic control, diabetes control requires a comprehensive management plan in which patients are educated and supported to make informed decisions about diet, exercise, weight control, blood glucose monitoring, taking medication, and regular screening for complications. Current evidence on the effectiveness of diabetes self-management education and support (D-SMES) interventions on blood glucose control is mixed, with some studies pointing to significant glycemic control benefits, whereas others have shown no significant benefits.

Objective: This systematic review and meta-analysis (SRMA) was conducted to evaluate the effectiveness of D-SMES interventions compared with usual care in controlling blood glucose levels among people living with type 2 diabetes (T2DM) in the World Health Organization (WHO) Africa Region and to describe the core components of D-SMES interventions.

Methods: We performed a SRMA of D-SMES interventions for managing T2DM in the WHO Africa Region. We searched PubMed, CINAHL, the Cochrane Central Register of Controlled Trials (CCRCT), and Google Scholar from inception to May 5, 2025, for studies that were randomized control trials that reported glycated hemoglobin (HbA1c) or fasting blood sugar (FBS) as outcome measures and were delivered to adults with T2DM. The methodological quality of the included studies was assessed via the Cochrane risk of bias tool (RoB2). Random effects model meta-analysis was used to estimate the population average pooled standard mean difference (Hedges' g) for HbA1c with 95% CIs.

Results: We screened the title/abstract records of 350 studies, of which 19 studies with a total of 3759 participants (1866 in the D-SMES group and 1893 in the usual care group) were included in the meta-analysis of HbA1c. The meta-analysis revealed a significant overall effect of D-SMES interventions on HbA1c among people living with T2DM in the WHO African Region (SMD = -0.468 with a 95% CI of -0.658 to -0.279, I2 = 85.5%). nine of the nineteen included studies reported significant effects. We would expect that in some 95% of all populations comparable to those in the analysis, the true effect size would fall between -1.27 and 0.34 (prediction interval). Of the 19 included studies, 15 had a low risk of bias, two had high risk, and two raised some concerns based on the Cochrane RoB 2 tool.

Conclusions: Diabetes self-management education and support interventions are moderately effective in controlling blood glucose levels in T2DM patients within the WHO African region.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022375732.

Keywords: WHO Africa Region; diabetes self-management education and support; meta-analysis; systematic review; type 2 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 study flow diagram for selecting studies to evaluate the effect of D-SMES interventions on HbA1c among people living with T2DM in the WHO African Region.
Figure 2
Figure 2
Effects of D-SMES interventions on HbA1c among people living with T2DM in the WHO Africa Region.
See this image and copyright information in PMC

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References

    1. International Dibetes Federation (IDF) . Diabetes Atlas, 11th Edition. Brussels: International Diabetes Federation (IDF) (2025).
    1. Ministry of Health-Ethiopia (MoH-E) . National non-communicable diseases management protocols. Addis Ababa: Ministry of Health-Ethiopia; (2021).
    1. Group UPDS . Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. (9131) 1998:837–53:352. doi: 10.1016/S0140-6736(98)07019-6 - DOI - PubMed
    1. World Health Organization (WHO). . Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: World Health Organization; (2013).
    1. Pearce G, Parke HL, Pinnock H, Epiphaniou E, Bourne CL, Sheikh A, et al. The PRISMS taxonomy of self-management support: derivation of a novel taxonomy and initial testing of its utility. J Health Serv Res Policy. (2016) 21:73–82. doi: 10.1177/1355819615602725 - DOI - PubMed

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