Diabetes Self-Care among South Asians in Western Countries: A Systematic Review

Abstract

Diabetes self-care is a patient-driven approach to managing diabetes, supported by healthcare professionals, that aims to empower patients to reduce long-term complications associated with the disease. This is particularly important for South Asians, who are among the populations most affected by diabetes. This mixed-methods systematic review synthesises both qualitative and quantitative evidence on diabetes self-care among South Asians living in Western countries and presents an integrated framework covering key areas for optimal self-care. The review followed PRISMA guidelines, and the protocol was registered with PROSPERO. Seven databases were searched for both qualitative and quantitative studies published between January 2000 and December 2024 to provide a comprehensive understanding of the evidence. The Joanna Briggs Institute critical appraisal checklist for quality assessment and the Risk of Bias V2 tool for trials were utilised, with data integrated through the Pillar Integration Process (PIP). Twenty studies met the inclusion criteria and were incorporated into this review. Most qualitative, cohort, and cross-sectional studies met over 70% of quality criteria, and all four randomised controlled trials demonstrated a low risk of bias. Qualitative findings highlighted the significance of culturally relevant education and support, while quantitative studies showed improvements in diabetes outcomes through educational and physical activity interventions. Common barriers included difficulties with self-monitoring, adherence to dietary guidelines, and implementing lifestyle changes. The PIP analysis identified three core pillars: providing adequate diabetes education, involving patients in care planning, and encouraging daily physical activity. Culturally tailored education, improved healthcare access, and patient-centred interventions are vital for enhancing self-care among South Asians. As this population's presence in Western countries increases, broader participation in self-care programmes can promote better integration and health outcomes.

Keywords: Diabetes; Immigrants; Self-care; Self-management; South asian; Type 2 diabetes; Western countries.