Diabetes education for Chinese adults with type 2 diabetes: A systematic review and meta-analysis of the effect on glycemic control.
OBJECTIVE
The purpose of this study is to systematically review evidence in English and Chinese publications to determine the size of glycemic effect of different diabetes education approaches for Chinese patients.


METHODS
CINAHL Plus, Embase, Ovid Medline, Scopus and the China National Knowledge Infrastructure database were searched. Studies were included if they were randomised controlled trials with a detailed description of education approach, with more than 50 Chinese-adult participants, reporting actual glycemic outcome and with at least 3-month follow-up. Data was systematically extracted and cross-checked by the authors. Methodological quality was assessed.


RESULTS
Fifty-three studies, including five English and 48 Chinese publications, were included. The overall weighted mean difference (WMD) in glycated haemoglobin (HbA1c) was -1.19% (-13mmol/mol). Ongoing regular education was most-commonly employed, with a reported WMD of -2.02% (-22mmol/mol). Glycemic control was further enhanced in studies using information reinforcement strategies.


CONCLUSIONS
Diabetes education in any format generates glycemic improvement for Chinese patients, but is particularly effective when an ongoing regular education is employed. Innovative strategies aligned with cultural concepts, such as employing patient examination to reinforce diabetes management knowledge and/or involving family in patient care deserve further trial to determine whether they enhance glycemic control in this group.
Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia. Electronic address: tammie.choi@monash.edu.
Tammie S T
TS
Choi
Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.
Zoe E
ZE
Davidson
Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.
Karen Z
KZ
Walker
Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.
Jia Hwa
JH
Lee
Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.
Claire
C
Palermo
D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods*
D001786:Blood Glucose; D006442:Glycated Hemoglobin
Chinese patients; Diabetes education; Education approach; Meta-analysis; Systematic literature review