Self-management interventions for type 2 diabetes: a systematic review

This paper systematically reviews published randomised controlled trials, to determine the educational focus and effectiveness of type 2 diabetes multicomponent self-management interventions. PubMed, PsycINFO, Web of Science and reference lists of included studies were searched for English-language articles published 2000–2010. Descriptive information was summarised; when possible, effect sizes were calculated. Fourteen studies, described in 19 articles, were reviewed: six one-on-one interventions; six group interventions; two interventions comprising both intervention types. Four studies used learning as an intervention method; seven used learning and planning; three used learning, planning and practising. Self-management interventions seemed effective for diet, self-monitoring of blood glucose, knowledge and diabetes specific quality of life (QoL); there were mixed results for exercise and clinical outcomes. Findings showed that dietary behaviour seemed relatively easy to change with self-management interventions. Group interventions with a practise component had the greatest potential to improve metabolic control. Self-management interventions had positive effects on diabetesspecific QoL, and interventions using a collaborative learning approach improved knowledge. Multi-component self-management interventions potentially lead to clinically relevant improvements in behaviour and some clinical parameters. Further research is needed to explain the mixed effects on exercise and to identify processes underlying behaviour change.