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Open Access 01-12-2018 | Research article

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

Authors: Amy T. Cunningham, Denine R. Crittendon, Neva White, Geoffrey D. Mills, Victor Diaz, Marianna D. LaNoue

Published in: BMC Health Services Research | Issue 1/2018

Abstract

Background

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.

Methods

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 I².

Results

HbA1c weighted mean difference between intervention and usual care participants was not significant: − 0.08%[− 0.40–0.23];χ² = 84.79 (p < .001), I² = 92%, (n = 1630). Four of five studies measuring QOL reported significant improvements for intervention participants.

Conclusions

Meta-analysis results showed non-significant effect of DSME on HbA1c in African-Americans. QOL did show improvement and is an important DSME outcome to measure in future trials. Further research is needed to understand effectiveness of DSME on HbA1c in this population.

Trial registration

PROSPERO registration: CRD42017057282.

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Title: The effect of diabetes self-management education on HbA1c and quality of life in African-Americans: a systematic review and meta-analysis
Authors: Amy T. Cunningham
Denine R. Crittendon
Neva White
Geoffrey D. Mills
Victor Diaz
Marianna D. LaNoue
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-018-3186-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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