Efficacy of Diabetes Education in Adults With Diabetes Mellitus Type 2 in Primary Care: A Systematic Review.

Abstract

To analyze the effect of different diabetes education methods on metabolic control, body mass index (BMI), and blood pressure. A systematic review was carried out. PubMed, Medline, Embase, Cochrane, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), CUIDEN, Ibecs, and Scopus databases were consulted. The search was done in May 2018. Studies included controlled clinical trials on diabetes education in primary care that were published in English and Spanish during the years 2011 to 2018. The post-intervention results were as follows: glycosylated hemoglobin concentration (HbA1c) ranged between -1.6% (individual education [IE]) and + 0.05% (mixed education [ME]). The values of BMI varied from -0.7% (group education [GE]) to -0.3% (GE). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) fluctuated. SBP varied from -8.5 mmHg (GE) to +2.9 mmHg (GE); DBP varied from -3.1 mmHg (GE) to -0.9 mmHg (GE). Total cholesterol ranged from -15.9/dL (GE) to +2 mg/dL (GE). LDL cholesterol ranged from -18.3 mg/dL (GE) to -7 mg/dL (ME). HDL cholesterol ranged from +0.8 mg/dL (IE) to +8.12 mg/dL (GE). Triglycerides varied from -21.1 mg/dL (GE) to +11.0 (GE). The most profound decrease in HbA1c was achieved using individual education. However, to decrease BMI, SBP, DBP, total cholesterol, LDL cholesterol, and triglycerides, group education was the most effective intervention. To obtain good metabolic control, it is necessary to address both clinical and psychological aspects, including modifying nutritional and dietary habits, monitoring medication, increasing knowledge of diabetes, and combining theoretical content with physical exercise programs. Reinforcement strategies are very important to achieve the objectives of educational programs.