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The Effects of Diabetes Self-Management Education and Support Program in Thailand: A Systematic Review and Meta-Analysis

Ratanaporn Jerawatana MSc, Thai CDE, APN¹, Apinya Siripitayakunkit PhD², Thunyarat Anothaisintawee MD³, Oraluck Pattanaprateep PhD⁴, Sirimon Reutrakul MD, CDCES⁵

Affiliation : ¹ Division of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Bangkok, Thailand ² Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ³ Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ⁴ Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand ⁵ Division of Endocrinology, Diabetes and Metabolism, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA

Background: Diabetes is a growing health problem worldwide. Diabetes self-management education and support (DSMES) program is a crucial component in promoting self-care in all people with diabetes. However, the practice in certain countries, including Thailand, is not yet standardized, thus the effectiveness of such program is unknown.
Objective: To evaluate the effectiveness of DSMES in Thailand. The outcomes were glycemic control, lipid levels, body mass index (BMI), quality of life (QoL), and diabetes knowledge.
Materials and Methods: The authors searched PubMed, Scopus, and ProQuest databases since their inception until March 2019 for randomized controlled trials conducted in Thailand that evaluated outcomes of DSMES programs. Meta-analyses were performed to pool mean differences (MD) of the outcomes.
Results: Seven studies, with 1,523 participants, were included. DSMES programs were conducted in different healthcare settings by health professionals from multiple disciplines. The results revealed that participants receiving DSMES had significantly lower hemoglobin A1c, MD –0.66% (95% CI –0.90 to –0.42), and FBG levels, MD –15.88 mg/dL (95% CI –20.95 to –10.79), than those who did not. Lipid levels, BMI, QoL, and diabetes knowledge, however, did not significantly differ.
Conclusion: Meta-analysis results showed that DSEMS is effective in improving glycemic control and should be promoted to combat the burden of this important health problem in Thailand.
Received 26 October 2020 | Revised 23 March 2021 | Accepted 26 March 2021

doi.org/10.35755/jmedassocthai.2021.06.12169

Keywords : Diabetes self-management education and support; DSMES; Glycemic control; Meta-analysis; Thailand


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