Skip to main content

Advertisement

SpringerLink
Log in

Diabetes self-care activities among patients with type 2 diabetes: A systematic review and meta-analysis

  • Review Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objectives

The important role of prevention in controlling chronic diseases such as diabetes, the major impact of self-care behaviors as preventive behaviors, and the lower cost of self-care measures should be considered. Therefore, this study was conducted to systematically review and meta-analyze the status of diabetes self-care activities status in type 2 diabetic patients worldwide.

Methods

As far as we know, our study is the first systematic based meta-analysis estimating the pooled score of diabetes self-care activities (SDSCA) and its dimensions among type 2 diabetic patients. Keywords were searched in Scopus, Web of Science, Google Scholar, PubMed, Cochrane, Ovid, and ProQuest databases from 2012 to 2022. The self-care pooled score estimates through a fixed-effects meta-analysis using STATA 15. Also, I2 statistic was used to determine heterogeneity across the articles.

Results

Seventeen studies on the diabetes self-care activities were included in the meta-analysis. Variation in pooled mean attributable to heterogeneity for exercise and self-care is zero, while the variation for foot cares, general diet, and blood testing were estimated to be 53, 20.6, and 81.4%, respectively (p < 0.01). The random effects based pooled mean was estimated as follows: foot care (FC) 2.02 (95% CI: 1.05, 2.98), general diet (GD) 3.91 (95% CI: 3.21, 4.60), and blood testing (BT) 1.82 (95% CI: 0.64, 3.01). As well as based on the fixed effects, the pooled mean of exercise (E) and the total score of self-care (TSC) were obtained 2.12 (95% CI: 1.77, 2.47) and 3.35 (95% CI: 2.96, 3.74), respectively.

Conclusion

The overall level of self-care was moderate and far from ideal. Dimensions of foot care, exercise, and blood glucose testing were also below average. Based on this evidence, policies to prevent diabetes should be directed toward educating patients on preventive activities. On the other hand, it is necessary to ensure that patients’ interpretations are in line with doctors’ recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Khan RMM, Chua ZJY, Tan JC, Yang Y, Liao Z, Zhao Y. From pre-diabetes to diabetes: diagnosis, treatments and translational research. Medicina. 2019;55(9):546.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Organization wh. Diabetes. Fact sheets https://www.who.int/news-room/fact-sheets/detail/diabetes. 2021. Accessed 7 Jun 2023.

  3. Caruso P, Longo M, Gicchino M, Scappaticcio L, Caputo M, Maiorino MI, et al. Long-term diabetic complications as predictors of foot ulcers healing failure: a retrospective study in a tertiary-care center. Diabetes Res Clin Pract. 2020;163: 108147.

    Article  PubMed  Google Scholar 

  4. Yuen L, Saeedi P, Riaz M, Karuranga S, Divakar H, Levitt N, et al. Projections of the prevalence of hyperglycaemia in pregnancy in 2019 and beyond: results from the International Diabetes Federation Diabetes Atlas. Diabetes Res Clin Pract. 2019;157: 107841.

    Article  PubMed  Google Scholar 

  5. Khosravizadeh O, Ahadinezhad B, Maleki A, Vosoughi P, Najafpour Z. Applying the health belief model and behavior of diabetic patients: a systematic review and meta-analysis. Clin Diabetol. 2021;10(2):200–11.

    Article  Google Scholar 

  6. Khosravizadeh O, Mohseni M, Baghian N, Maleki A, Hashtroodi A, Yari S. Front-line staff’s perspective on patient safety culture in Iranian medical centers: a systematic review and meta-analysis. Int J Risk Saf Med. 2020;31(4):193–207.

    Article  PubMed  Google Scholar 

  7. Alghadeer SM, Alsuwayni B, Almuwayjid AK, Almadi MS, Mubarak AM, Khunayn RMb, et al. Glycemic control and management in pharmacist-led diabetic clinic vs. physician-led diabetic clinic. Medicina. 2022;58(1):14.

    Article  Google Scholar 

  8. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–34.

    Article  PubMed  Google Scholar 

  9. Lo CK-L, Mertz D, Loeb M. Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol. 2014;14(1):1–5.

    Article  Google Scholar 

  10. Jackson IL, Onung SI, Oiwoh EP. Self-care activities, glycaemic control and health-related quality of life of patients with type 2 diabetes in a tertiary hospital in Nigeria. Diabetes Metab Syndr. 2021;15(1):137–43.

    Article  CAS  PubMed  Google Scholar 

  11. Mogre V, Abanga ZO, Tzelepis F, Johnson NA, Paul C. Psychometric evaluation of the summary of diabetes self-care activities measure in Ghanaian adults living with type 2 diabetes. Diabetes Res Clin Pract. 2019;149:98–106.

    Article  PubMed  Google Scholar 

  12. Sukkarieh-Haraty O, Howard E. Psychometric properties of the Arabic version of the summary of diabetes self-care activities instrument. Res Theory Nurs Pract. 2016;30(1):60–9.

    Article  PubMed  Google Scholar 

  13. Alhaiti AH, Senitan M, Dator WLT, Sankarapandian C, Baghdadi NA, Jones LK, et al. Adherence of type 2 diabetic patients to self-care activity: tertiary care setting in Saudi Arabia. J Diabetes Res. 2020;2020:4817637.

  14. ElGerges NS. Effects of therapeutic education on self-efficacy, self-care activities and glycemic control of type 2 diabetic patients in a primary healthcare center in Lebanon. J Diabetes Metab Disord. 2020;19(2):813–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Ashur ST, Shah SA, Bosseri S, Fah TS, Shamsuddin K. Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya. Libyan J Med. 2016;11:31086.

  16. Akritidou S, Husted GR, Kazakos K, Olesen K. The effect of using interactive communication tools in adults with type-2 diabetes. Nursing Reports. 2017;7(1):1–3.

    Article  Google Scholar 

  17. ArdaSürücü H, BüyükkayaBesen D, Erbil EY. Empowerment and social support as predictors of self-care behaviors and glycemic control in individuals with type 2 diabetes. Clin Nurs Res. 2018;27(4):395–413.

    Article  Google Scholar 

  18. Marques MB, Coutinho JFV, Martins MC, Lopes MVdO, Maia JC, Silva MJd. Educational intervention to promote self-care in older adults with diabetes mellitus. Revista da Escola de Enfermagem da USP. 2019;53:e03517.

  19. Mulligan K, McBain H, Lamontagne-Godwin F, Chapman J, Flood C, Haddad M, et al. Barriers to effective diabetes management–a survey of people with severe mental illness. BMC Psychiatry. 2018;18(1):1–15.

    Article  Google Scholar 

  20. Tol A, Shojaeezadeh D, Eslami A, Alhani F, Mohajeritehrani M, Baghbanian A, et al. Evaluation of self-care practices and relative components among type 2 diabetic patients. J Educ Health Promot. 2012;1:19.

  21. Al-Mallah AN, Tawfiq NO, Dizaye K. The role of a clinical pharmacist in lifestyle modification in type 2 diabetic patients with peripheral neuropathy in Erbil, Iraq. JPMC. 2017;3(2):57.

    Google Scholar 

  22. Kueh YC, Morris T, Ismail A-A-S. The effect of diabetes knowledge and attitudes on self-management and quality of life among people with type 2 diabetes. Psychol Health Med. 2017;22(2):138–44.

    Article  PubMed  Google Scholar 

  23. Bala R, Srivastava A, Potsangbam T, Anal L, Ningthoujam GD. Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: a scenario from the north east. Diabetes Metab Syndr. 2021;15(1):93–8.

    Article  CAS  PubMed  Google Scholar 

  24. Kang YM, Kim HJ, Lee T-Y, Ku B-J. Effect of glucose control, SDSCA and quality of life of D-chiro-inositol (DCI) in patients with type 2 diabetes: a path analysis. Journal of the Korea Academia-Industrial cooperation Society. 2018;19(10):243–53.

    Google Scholar 

  25. Shin KS, Lee EH. Relationships of health literacy to self-care behaviors in people with diabetes aged 60 and above: empowerment as a mediator. J Adv Nurs. 2018;74(10):2363–72.

    Article  PubMed  Google Scholar 

  26. Ausili D, Bulgheroni M, Ballatore P, Specchia C, Ajdini A, Bezze S, et al. Self-care, quality of life and clinical outcomes of type 2 diabetes patients: an observational cross-sectional study. Acta Diabetol. 2017;54(11):1001–8.

    Article  PubMed  Google Scholar 

  27. Rajput SA, Ashraff S, Siddiqui M. Diet and management of type II diabetes mellitus in the United Kingdom: a narrative review. Diabetology. 2022;3(1):72–8.

    Article  Google Scholar 

  28. Degefa G, Wubshet K, Tesfaye S, Hirigo AT. Predictors of adherence toward specific domains of diabetic self-care among type-2 diabetes patients. Clin Med Insights Endocrinol Diabetes. 2020;13:1179551420981909.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Mohandas A, Bhasin S, Upadhyay M, Madhu S. Diabetes self care activities among adults 20 years and above residing in a resettlement colony in East Delhi. Indian J Public Health. 2018;62(2):104.

    Article  PubMed  Google Scholar 

  30. Adu MD, Malabu UH, Malau-Aduli AE, Malau-Aduli BS. Enablers and barriers to effective diabetes self-management: a multi-national investigation. PLoS ONE. 2019;14(6): e0217771.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Grewal EK, Campbell RB, Booth GL, McBrien KA, Hwang SW, O’Campo P, et al. Using concept mapping to prioritize barriers to diabetes care and self-management for those who experience homelessness. Int J Equity Health. 2021;20(1):158.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Stephani V, Opoku D, Beran D. Self-management of diabetes in Sub-Saharan Africa: a systematic review. BMC Public Health. 2018;18(1):1–11.

    Article  Google Scholar 

  33. Iwuala S, Olamoyegun M, Sabir A, Fasanmade O. The relationship between self-monitoring of blood glucose and glycaemic control among patients attending an urban diabetes clinic in Nigeria. Ann Afr Med. 2015;14(4):182–7.

    Article  PubMed  Google Scholar 

  34. Kassahun A, Gashe F, Mulisa E, Rike WA. Nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital, Oromia Region, Ethiopia. J Pharm Bioallied Sci. 2016;8(2):124–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. de-Graft Aikins A, Awuah RB, Pera TA, Mendez M, Ogedegbe G. Explanatory models of diabetes in urban poor communities in Accra, Ghana. Ethn Health. 2015;20(4):391–408.

    Article  PubMed  Google Scholar 

  36. Coffey L, Mahon C, Gallagher P. Perceptions and experiences of diabetic foot ulceration and foot care in people with diabetes: a qualitative meta-synthesis. Int Wound J. 2019;16(1):183–210.

    Article  PubMed  Google Scholar 

  37. Pourkazemi A, Ghanbari A, Khojamli M, Balo H, Hemmati H, Jafaryparvar Z, et al. Diabetic foot care: knowledge and practice. BMC Endocr Disord. 2020;20(1):1–8.

    Article  Google Scholar 

  38. Adarmouch L, Elyacoubi A, Dahmash L, El Ansari N, Sebbani M, Amine M. Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco. J Clin Transl Endocrinol. 2017;7:54–9.

    PubMed  PubMed Central  Google Scholar 

  39. Marinho FS, Moram C, Rodrigues PC, Leite NC, Salles GF, Cardoso CR. Treatment adherence and its associated factors in patients with type 2 diabetes: results from the Rio de Janeiro type 2 diabetes cohort study. J Diabetes Res. 2018;2018. https://doi.org/10.1155/2018/8970196

  40. Alosaimi FD, Labani R, Almasoud N, Alhelali N, Althawadi L, AlJahani DM. Associations of foot ulceration with quality of life and psychosocial determinants among patients with diabetes; a case-control study. J Foot Ankle Res. 2019;12(1):1–11.

    Article  Google Scholar 

  41. Amer FA, Mohamed MS, Elbur AI, Abdelaziz SI, Elrayah ZA. Influence of self-efficacy management on adherence to self-care activities and treatment outcome among diabetes mellitus type 2. Pharm Pract (Granada). 2018;16(4):1274.

  42. Ketema DB, Leshargie CT, Kibret GD, Assemie MA, Alamneh AA, Kassa GM, et al. Level of self-care practice among diabetic patients in Ethiopia: a systematic review and meta-analysis. BMC Public Health. 2020;20(1):1–12.

    Article  Google Scholar 

  43. Mutyambizi C, Pavlova M, Hongoro C, Groot W. Inequalities and factors associated with adherence to diabetes self-care practices amongst patients at two public hospitals in Gauteng, South Africa. BMC Endocr Disord. 2020;20(1):1–10.

    Article  Google Scholar 

  44. Rajasekharan D, Kulkarni V, Unnikrishnan B, Kumar N, Holla R, Thapar R. Self care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India. Ann Med Health Sci Res. 2015;5(1):59–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Adhikari M, Devkota HR, Cesuroglu T. Barriers to and facilitators of diabetes self-management practices in Rupandehi, Nepal - multiple stakeholders’ perspective. BMC Public Health. 2021;21(1):1269.

    Article  PubMed  PubMed Central  Google Scholar 

  46. De Man J, Aweko J, Daivadanam M, Alvesson HM, Delobelle P, Mayega RW, et al. Diabetes self-management in three different income settings: cross-learning of barriers and opportunities. PLoS ONE. 2019;14(3): e0213530.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Liu Y, Jiang J, You W, Gong D, Ma X, Wu M, et al. Exploring facilitators and barriers to self-management engagement of Chinese people with type 2 diabetes mellitus and poor blood glucose control: a descriptive qualitative study. BMC Endocr Disord. 2022;22(1):294.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P, Charupoonphol P. Barriers to effective diabetes mellitus self-management (DMSM) practice for glycemic uncontrolled type 2 diabetes mellitus (T2DM): a socio cultural context of Indonesian communities in West Sulawesi. Eur J Investig Health Psychol Educ. 2019;10(1):250–61.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran

    Omid Khosravizadeh & Bahman Ahadinezhad

  2. Health Products Safety Research Center, Qazvin University of Medical Sciences, Qazvin, Iran

    Aisa Maleki

  3. Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran

    Aisa Maleki, Sama Yousefy & Zeinab Momeni

Authors
  1. Omid Khosravizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bahman Ahadinezhad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aisa Maleki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sama Yousefy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zeinab Momeni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aisa Maleki.

Ethics declarations

Ethics consideration

The present study has ethical approval from the ethics committee of Qazvin University of Medical Sciences (ethics code IR.QUMS.REC.1401.329).

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khosravizadeh, O., Ahadinezhad, B., Maleki, A. et al. Diabetes self-care activities among patients with type 2 diabetes: A systematic review and meta-analysis. Int J Diabetes Dev Ctries 44, 10–19 (2024). https://doi.org/10.1007/s13410-023-01214-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-023-01214-3

Keywords

Search

Navigation