The role of discharge planning services in continuity of care for patients with diabetes: a scoping review

Background Diabetes has become a major global public health challenge. Increasing pressure on healthcare systems and shorter hospital stays highlight the importance of effective discharge planning in enhancing post-discharge self-management and continuity of care for people with diabetes. Aim This scoping review aimed to map existing discharge planning practices that support continuity of care for people with diabetes and to inform the optimization of intervention programs in clinical practice. Methods The review was conducted according to the Joanna Briggs Institute (JBI) methodology and reported in accordance with the PRISMA-ScR guidelines. Eligible studies included randomized controlled trials and quasi-experimental studies investigating discharge planning services for adults with type 1 diabetes, type 2 diabetes, or gestational diabetes during the hospital-to-home transition. English and Chinese databases (PubMed, CINAHL, Embase, Web of Science, CNKI, Wanfang, VIP, and SinoMed) were systematically searched for studies published between January 2020 and June 2025. Study selection and data extraction were independently performed by two reviewers. The included studies were synthesized using descriptive and thematic analyses, and methodological quality was assessed using the Cochrane Risk of Bias 2 tool for randomized controlled trials and the JBI critical appraisal checklist for quasi-experimental studies. Results A total of 20 studies met the inclusion criteria. Most studies involved adults with type 2 diabetes or mixed populations of adults with type 1 and type 2 diabetes. Technology-enabled components were incorporated into several interventions, whereas explicit theoretical or conceptual foundations were reported in only a subset of studies. Intervention timing varied across studies, with some interventions initiated during hospitalization and continued into the post-discharge period. Delivery approaches included in-person, digital, and hybrid formats. Core components included patient assessment, diabetes education, lifestyle guidance, medication and glucose management, complication prevention, and psychological support. Reported outcomes primarily included HbA1c, self-management-related outcomes, quality of life, and discharge readiness. Outcome assessments were commonly conducted at discharge, whereas post-discharge follow-up assessments were often performed approximately 3 months after discharge. Conclusion Discharge planning services for patients with diabetes during the hospital-to-home transition were commonly described as multicomponent interventions intended to support continuity of care. However, variations in delivery formats, outcome measures, follow-up periods, evaluation methods, and reporting quality highlight the need for further research with clearer intervention descriptions, consistent outcome measures, process evaluations, stakeholder perspectives, and longer-term outcome assessments. Future initiatives should prioritize continuous and adaptable discharge planning service models that are feasible, acceptable, and responsive to the needs of individuals with diabetes across different care contexts. Systematic Review Registration https://archive.org/details/osf-registrations-3bnyq-v1 , identifier doi: 10.17605/OSF.IO/3BNYQ .