Interventions for self-management of type 2 diabetes: An integrative review.

The review combined many intervention types, lengths, delivery methods and facilitators, so findings cannot be compared as if the interventions were the same. Many programmes were multi-modal, including education, coaching, technology or lifestyle components together, so the effect of any single component cannot be separated. Only 21 of 59 studies, or 35.5%, addressed intervention fidelity. Most diet, physical activity, self-efficacy and distress outcomes were self-reported, which may overstate behaviour change. Follow-up was mostly at 6 or 12 months, and some positive effects did not persist, so long-term maintenance is uncertain. The search was limited to English-language peer-reviewed quantitative studies of adults, so non-English or qualitative evidence may be missing. Because systematic reviews, meta-analyses and primary studies were included together, some findings may be duplicated. Attrition was reported inconsistently; five studies did not report attrition.

The authors reported that this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Do not read this review as proof that diabetes self-management education, apps, coaching, problem solving, mindfulness or cognitive behavioural therapy reliably improves long-term blood sugar control. Many studies showed only small, short-term or within-group HbA1c changes, effects were inconsistent, and interventions often combined several components so one part cannot be credited.