title: Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control.
abstract: Assess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes.
  
  
  
  We searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants' knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting.
  
  
  
  This review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours ≥10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C>9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%).
  
  
  
  This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels.
  
  
  
  The data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C.
authors.affiliation: Health Matters, Inc., Chapel Hill, NC, USA. Electronic address: cchrvala@centurylink.net.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Chrvala
authors.affiliation: American Association of Diabetes Educators, 200 W. Madison Street, Chicago, IL 60606, USA. Electronic address: dsherr@aadenet.org.
authors.forename: Dawn
authors.initials: D
authors.lastname: Sherr
authors.affiliation: American Association of Diabetes Educators, 200 W. Madison Street, Chicago, IL 60606, USA. Electronic address: rlipman@aadenet.org.
authors.forename: Ruth D
authors.initials: RD
authors.lastname: Lipman
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: Control; Diabetes self-management education; Glycemic; Systematic review; Type 2 diabetes