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Chowdhury HA, Harrison CL, Siddiquea BN, Tissera S, Afroz A, Ali L, Joham AE, Billah B. The effectiveness of diabetes self-management education intervention on glycaemic control and cardiometabolic risk in adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis. PLoS One 2024; 19:e0297328. [PMID: 38306363 PMCID: PMC10836683 DOI: 10.1371/journal.pone.0297328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/01/2024] [Indexed: 02/04/2024] Open
Abstract
Diabetes mellitus (DM) poses a significant challenge to public health. Effective diabetes self-management education (DSME) interventions may play a pivotal role in the care of people with type 2 diabetes mellitus (T2DM) in low- and middle-income countries (LMICs). A specific up-to-date systematic review is needed to assess the effect of DSME interventions on glycaemic control, cardiometabolic risk, self-management behaviours, and psychosocial well-being among T2DM across LMICs. The MEDLINE, Embase, CINAHL, Global Health, and Cochrane databases were searched on 02 August 2022 and then updated on 10 November 2023 for published randomised controlled trials (RCTs) and quasi-experimental studies. The quality of the studies was assessed, and a random-effect model was used to estimate the pooled effect of diabetes DSME intervention. Heterogeneity (I2) was tested, and subgroup analyses were performed. Egger's regression test and funnel plots were used to examine publication bias. The risk of bias of the included studies was assessed using the Cochrane risk-of-bias tool for randomized trial (RoB 2). The overall assessment of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. A total of 5893 articles were retrieved, and 44 studies (n = 11838) from 21 LMICs met the inclusion criteria. Compared with standard care, pooled analysis showed that DSME effectively reduced the HbA1c level by 0.64% (95% CI: 0.45% to 0.83%) and 1.27% (95% CI: -0.63% to 3.17%) for RCTs and quasi-experimental design studies, respectively. Further, the findings showed an improvement in cardiometabolic risk reduction, diabetes self-management behaviours, and psychosocial well-being. This review suggests that ongoing support alongside individualised face-to-face intervention delivery is favourable for improving overall T2DM management in LMICs, with a special emphasis on countries in the lowest income group.
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Affiliation(s)
- Hasina Akhter Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation–MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bodrun Naher Siddiquea
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sanuki Tissera
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Afsana Afroz
- Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Liaquat Ali
- Pothikrit Institute of Health Studies (PIHS), Dhaka, Bangladesh
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation–MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Departments of Endocrinology and Diabetes, Monash Health, Melbourne, Australia
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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DEWI RISTIKURNIA, MAHMUDIONO TRIAS, YUNIAR CINDRATRI, ZEBADIA EURIKA, SAHILA NUR, WIJANARKO MUTIARAARSYAVIDIANINGGAR, HALIMAN CHIKADEWI, ADRIANUS RAHMANIA, TANG SHIRLEYGEEHOON. Nutrition education has significant impact on perceived barriers to healthy diet among adults with and without COVID-19 history. J Public Health Afr 2023; 14:2430. [PMID: 38162330 PMCID: PMC10755509 DOI: 10.4081/jphia.2023.2430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 11/13/2023] [Indexed: 01/03/2024] Open
Abstract
Healthy diet is an important tool to lower the risk and severity of COVID-19 infection. Low diet quality is usually caused by perceived barriers that stop people to do certain behavior. Perceived barriers can be overcome by implementing proper method such as conducting nutrition education. This study aimed to analyze the impact of nutrition education on perceived barrier to healthy diet among adults with and without covid-19 history in Padang, Indonesia. This study was a pre-experimental study using pre and post-design. This study was conducted on 70 adults with or without COVID-19 infection history, residing in Padang, Indonesia. The intervention was given in the form of nutrition education. Difference test was conducted to assess the impact of nutrition education on respondents' nutrition knowledge and perceived barriers. The majority of the respondents both with and without COVID-19 history (71.4 and 80%) had medium level of nutritional knowledge before the intervention. After the intervention, there was a significant (P<0.05) improvement on respondents' nutritional knowledge for both groups (100%). The result also showed 40% of the respondents with COVID-19 history had medium level of perceived barriers, while 28.6% respondents without COVID-19 history (65.7%) had medium level of perceived barriers before the intervention. A significant improvement (P<0.05) also showed on respondents' perceived barriers after the intervention. On both groups more 90% of the respondents only had low level of perceived barriers. The result shows that nutrition education has significant impact both on respondents' nutritional knowledge and perceived barriers.
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Affiliation(s)
- RISTI KURNIA DEWI
- Department of Nutrition Science, Faculty of Public Health, Universitas Andalas, Padang
| | - TRIAS MAHMUDIONO
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya
| | - CINDRA TRI YUNIAR
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung
| | - EURIKA ZEBADIA
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya
| | - NUR SAHILA
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya
| | | | - CHIKA DEWI HALIMAN
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya
| | - RAHMANIA ADRIANUS
- Medical Staff Secretariat of Internal Medicine, RSUP Dr. M. Djamil Padang, Padang, Indonesia
| | - SHIRLEY GEE HOON TANG
- Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Phuc TT, Duc TQ, Quynh Chi VT, Quang PN. The prevalence of excess weight among Vietnamese adults: A pooled analysis of 58 studies with more 430 thousand participants over the last three decades. Nutr Health 2023; 29:443-452. [PMID: 36285514 DOI: 10.1177/02601060221129440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) associated with excess weight as a significant risk factor, but few studies have been sufficient enough to examine the magnitude of excess weight of Vietnamese adults. This review aimed to provide a generalized estimate of the prevalence of excess weight among Vietnamese adults. METHODS PubMed, Scopus and national database were used to identify articles published up to May 2022. The Newcastle-Ottawa Quality Assessment Scale was used to rate the study quality. The data was analyzed using RStudio software, and the combined effects were estimated using random-effects meta-analysis. The Cochran's Q-test and the I2 test were employed to examine heterogeneity, and subgroups were conducted. Egger's test and visual inspection of the symmetry in funnel plots were used to determine publication bias. RESULTS 58 studies with 432,585 participants from 1998 to 2020 were suitable for inclusion in the final model after meeting the prerequisites. Over the last three decades, the combined pooled prevalence of excess weight among adults in Vietnam was 20.3% (95% CI: 15.2-26.6). Notably, this proportion has a tendency to go up between 1998 and 2020. Moreover, rates of excess weight were found to be substantially higher in non-national studies (23.1%, 17.3-30.1) compared to national studies (8.4%, 3.6-18.3) and significantly higher when Asian and Pacific cut-offs (27.6%, 20.0-36.7) were used rather than WHO classification (11.2%, 6.7-18.0). CONCLUSION The findings suggest healthcare professionals and policymakers should focus more on designing and implementing preventive initiatives to lower the rising prevalence of excess weight adults in Vietnam.
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Affiliation(s)
- Tran Thai Phuc
- Department of Nursing, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | | | | | - Phan Ngoc Quang
- The Center Service For Technology Science Of Medi-Phar, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
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Butayeva J, Ratan ZA, Downie S, Hosseinzadeh H. The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: A systematic review. J Diabetes 2023; 15:724-735. [PMID: 37407516 PMCID: PMC10509520 DOI: 10.1111/1753-0407.13436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/03/2023] [Indexed: 07/07/2023] Open
Abstract
Diabetes imposes an increasing health and economic burden on individuals living with it and their societies worldwide. Glycemic control is necessary to reduce morbidity and mortality of type 2 diabetes mellitus (T2DM). Self-management is the primary tool for managing diabetes. Health literacy (HL) is the primary driver of self-management activities. The aim of this review is to evaluate the impact of HL interventions on glycemic control and self-management outcomes among T2DM. MEDLINE, CINAHL, PubMed, Cochrane, Scopus, and Web of Science were searched for eligible papers. Fifteen randomized controlled trials published in English between 1997 and 2021, used HL-driven intervention, and measured the level of glycohemoglobin A1c (HbA1c) and self-management of T2DM patients were included in this review. The findings showed that HL-driven intervention had a positive impact on glycemic control and improved self-management behaviors. The level of glycemic control and self-management skills were improved through individual and telephone-based intervention respectively. Community worker-led interventions were effective in improvements in diabetes knowledge and self-care behaviors; however, nurse-led interventions were effective in glycemic control. Better glycemic control is achieved in hospital settings compared to outpatient settings. HL interventions yielded better improvement in self-management among people with longer diabetes duration (more than 7 years). It was possible to achieve a large reduction in HbA1c level after a 3-month intervention in hospital settings. HL-driven interventions are effective in glycemic and diabetes self-management outcomes.
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Affiliation(s)
- Jamila Butayeva
- School of Health & Society, Faculty of the Arts, Social Sciences and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
| | - Zubair Ahmed Ratan
- School of Health & Society, Faculty of the Arts, Social Sciences and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
| | - Sue Downie
- Discipline of Medical and Exercise Science, Faculty of Science, Medicine and Health, School of MedicineUniversity of WollongongWollongongNew South WalesAustralia
| | - Hassan Hosseinzadeh
- School of Health & Society, Faculty of the Arts, Social Sciences and HumanitiesUniversity of WollongongWollongongNew South WalesAustralia
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Nunes LB, Santos JCD, Reis IA, Torres HDC. [Evaluation of the behavioral program in type 2 diabetes mellitus: a randomized clinical trial]. CIENCIA & SAUDE COLETIVA 2023; 28:851-862. [PMID: 36888868 DOI: 10.1590/1413-81232023283.10102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 09/12/2022] [Indexed: 03/08/2023] Open
Abstract
The scope of this article was to evaluate the effect of the behavioral group education program and telephone intervention in modifying psychological attitudes, enhancing empowerment, and self-care practices aimed at improving clinical control in type 2 diabetes mellitus. It involved a randomized cluster clinical trial, carried out with 199 people with diabetes. In order to perform intragroup comparisons (final and initial phases) and between groups with respect to the indices of the psychological attitude, empowerment, self-care and glycated hemoglobin level variables, the Generalizing Estimating Equation (GEE) approach was used. In all analyses, a 5% significance level and 95% confidence interval were used. When compared to the CG, the IG showed a significant reduction in the mean values of glycated hemoglobin (95%CI: -1.49 to -0.45), a statistically significant increase in the change in psychological attitude scores (95%CI: 9.70 to 15.40), on the empowerment scale (95%CI: 0.81 to 2.72) and adherence to self-care practices (95%CI: 1.44 to 2.10) at the end of the study. The behavioral program proved to be capable of modifying psychological attitudes, improving empowerment, self-care practices and clinical control.
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Affiliation(s)
- Laura Barbosa Nunes
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Jéssica Caroline Dos Santos
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Ilka Afonso Reis
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Heloísa de Carvalho Torres
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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