Effectiveness of self-management intervention in community on management of type 2 diabetes mellitus: a systematic review
Abstract
Background: The rising global prevalence of type 2 diabetes mellitus (T2DM) highlights the urgent need for sustainable management strategies, such as community-based self-management interventions.
Objective: This systematic review aimed to evaluate the effectiveness of these interventions on diabetes control and quality of life among adults with T2DM.
Methods: Following PRISMA 2020 guidelines, seven Randomized Controlled Trials (RCTs) published between 2020 and 2024 were analyzed. These studies included 1,193 participants from diverse countries like the United States, Ghana, China, Nepal, and Taiwan. The interventions tested included digital education, programs led by community health workers (CHWs), and community-based cooking programs.
Results: Most studies reported improvements in HbA1c, self-care behaviors, and quality of life. The effectiveness varied depending on intervention duration, sample size, and socio-cultural context. Multicomponent interventions that combined education, social support, and community health worker (CHW) engagement produced the most consistent and positive outcomes.
Conclusion: Although these interventions show promise in improving glycemic control, self-care behaviors, and quality of life, the limited number of studies, heterogeneity of interventions, and methodological biases restrict the overall strength of the evidence. Therefore, further long-term randomized controlled trials (RCTs) in diverse settings, as well as cost-effectiveness evaluations, are needed before large-scale implementation.
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References
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24. Tanaka R, Shibayama T, Sugimoto K, Hidaka K. Diabetes self-management education and support for adults with newly diagnosed type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2020;169:108480. doi:10.1016/j.diabres.2020.108480
25. Captieux M, Pearce G, Parke H, Wild S, Taylor SJC, Pinnock H. Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. Lancet. 2017;390:S32. doi:10.1016/s0140-6736(17)32967-7
26. Tang Y, Soh KL, Gan WY, Zhou J, Soh KG. The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis. BMC Public Health. 2025;25(1):ahead of print. doi:10.1186/s12889-025-23073-9
27. Pamungkas RA, Chamroonsawasdi K. HbA1c reduction and weight-loss outcomes: a systematic review and meta-analysis of community-based intervention trials among patients with type 2 diabetes mellitus. Int J Diabetes Dev Ctries. 2019;39(2):394-407. doi:10.1007/s13410-018-0708-0
28. Alaofè H, Asaolu I, Ehiri J, et al. Community Health Workers in Diabetes Prevention and Management in Developing Countries. Ann Glob Heal. 2017;83(3-4):661-675. doi:10.1016/j.aogh.2017.10.009
29. Evans J, Ha H, White PT. Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis. BMJ Open . 2025;15(7). doi:10.1136/bmjopen-2024-096651
2. Wang L, Peng W, Zhao Z, et al. Prevalence and Treatment of Diabetes in China, 2013-2018. Jama. 2021;326(24):2498-2506. doi:https://doi.org/10.1001/jama.2021.22208
3. Wahidin M, Achadi A, Besral B, et al. Projection of diabetes morbidity and mortality till 2045 in Indonesia based on risk factors and NCD prevention and control programs. Sci Rep. 2024;14(1):1-17. doi:https://doi.org/10.1038/s41598-024-54563-2
4. Liu W, Ren B, Zhu X, Lin S, Lei S, Feng B. Self-management knowledge, attitudes, and behaviors among patients with type 2 diabetes mellitus in a community of western China: A cross-sectional study. Geriatr Nurs (Minneap). 2025;61(ahead of print):34-40. doi:https://doi.org/10.1016/j.gerinurse.2024.10.075
5. Damgaard AJ, Primdahl J, Esbensen BA, Latocha KM, Bremander A. Self-management support needs of patients with inflammatory arthritis and the content of self-management interventions: a scoping review. Semin Arthritis Rheum. 2023;60. doi:https://doi.org/10.1016/j.semarthrit.2023.152203
6. Lai YC, Chen YS, Jiang Y Der, et al. Diabetes self-management education on the sustainability of metabolic control in type 2 diabetes patients: Diabetes share care program in Taiwan. J Formos Med Assoc. 2024;123(2):283-292. doi:10.1016/j.jfma.2023.09.010
7. Jang GY, Chang SJ, Noh JH. Relationships Among Health Literacy, Self-Efficacy, Self-Management, and HbA1c Levels in Older Adults with Diabetes in South Korea: A Cross-Sectional Study. J Multidiscip Healthc. 2024;17:409-418. doi:https://doi.org/10.2147/JMDH.S448056
8. Zainab Z, Sulaeman S, Hasanuddin I. Perilaku Pengendalian Diabetes Mellitus Tipe 2 Terhadap Kadar Gula Darah. J Ris Kesehat Poltekkes Depkes Bandung. 2024;16(2):613-621. doi:10.34011/juriskesbdg.v16i2.2361
9. Erlina L, Avianti N. Pengalaman Pasien Dalam Self-Management Diabetes Sebagai Indikator Instrumen Aplikasi E-Monitoring Diabetes: Studi Kualitatif. J Ris Kesehat Poltekkes Depkes Bandung. 2023;15(1):87-92.
10. Shirvani T, Javadivala Z, Azimi S, et al. Community-based educational interventions for prevention of type II diabetes: a global systematic review and meta-analysis. Syst Rev. 2021;10(1):1-12. doi:https://doi.org/10.1186/s13643-021-01619-3
11. Kim MT, Kim KB, Ko J, et al. Health Literacy and Outcomes of a Community-Based Self-Help Intervention: A Case of Korean Americans with Type 2 Diabetes. Nurs Res. 2020;69(3):210-218. doi:DOI: 10.1097/NNR.0000000000000409
12. Abbott L, Slate E, Graven L, Lemacks J, Grant J. Fatalism, social support and self-management perceptions among rural african americans living with diabetes and pre-diabetes. Nurs Reports. 2021;11(2):242-252. doi:https://doi.org/10.3390/nursrep11020024
13. Xia Z, Mao F, Jiang Y, Dong W, Dong J. Study on the long-term and short-term effects of community-based health self-management group activities on comprehensive control of type 2 diabetes. Chinese Gen Pract J. 2024;1(2):106-112. doi:https://doi.org/10.1016/j.cgpj.2024.05.003
14. Shirinzadeh M, Afshin-Pour B, Angeles R, Gaber J, Agarwal G. The effect of community-based programs on diabetes prevention in low- and middle-income countries: A systematic review and meta-analysis. Global Health. 2019;15(1). doi:https://doi.org/10.1186/s12992-019-0451-4
15. Barker TH, Stone JC, Sears K, et al. The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evid Synth. 2023;21(3):494-506. doi:10.11124/JBIES-22-00430
16. Asante E, Carter G, McAneney H, Bam V, Sarfo-Kantanka O PG. Nurse-Led Mobile Phone Intervention to Promote Self-Management in Type 2 Diabetes in Ghana: A Randomized Controlled Trial. Sci Diabetes Self-Management Care. 2024;51(1):85-99. doi:doi: 10.1177/26350106241293113
17. Chen J, Lv L, Zhao X, et al. The effectiveness of a community-based online low-glycaemic index diet and lifestyle recommendations intervention for people with type 2 diabetes: a randomized controlled trial. Arch Public Heal. 2025;83(1):ahead of print. doi:10.1186/s13690-025-01552-0
18. Paudel G, Vandelanotte C, Huda MM, Dahal PK, Rawal L. The effect of a community-based health behaviour intervention on healthcare services use among people with type 2 diabetes in Nepal. Clin Epidemiol Glob Heal. 2025;32(February, ahead of print):101954. doi:https://doi.org/10.1016/j.cegh.2025.101954
19. Porterfield L, Santiago Delgado Z, Patel PG, Goodman ML, Campbell KM, Vaughan EM. Preparing Community Health Workers to Empower Latino(a)s With Diabetes: A Real-World Implementation Study. Sci Diabetes Self-Management Care. 2024;50(1):56-64. doi:https://doi.org/10.1177/26350106231220012
20. Hsu YJ, Chen YH, Lin K Der, et al. Clinical outcomes and oral health-related quality of life after periodontal treatment with community health worker strategy in patients with type 2 diabetes: A randomized controlled study. Int J Environ Res Public Health. 2021;18(16):1-14. doi:https://doi.org/10.3390/ijerph18168371
21. Williams A, Shrodes JC, Radabaugh JN, et al. Outcomes of Cooking Matters for Diabetes: A 6-week Randomized, Controlled Cooking and Diabetes Self-Management Education Intervention. J Acad Nutr Diet. 2023;123(3):477-491. doi:https://doi.org/10.1016/j.jand.2022.07.021
22. Dong C, Liu R, Huang Z, Yang Y, Sun S, Li R. Effect of exercise interventions based on family management or self-management on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr. 2023;15(1). doi:https://doi.org/10.1186/s13098-023-01209-4
23. Hildebrand JA, Billimek J, Lee JA, et al. Effect of diabetes self-management education on glycemic control in Latino adults with type 2 diabetes: A systematic review and meta-analysis. Patient Educ Couns. 2020;103(2):266-275. doi:10.1016/j.pec.2019.09.009
24. Tanaka R, Shibayama T, Sugimoto K, Hidaka K. Diabetes self-management education and support for adults with newly diagnosed type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2020;169:108480. doi:10.1016/j.diabres.2020.108480
25. Captieux M, Pearce G, Parke H, Wild S, Taylor SJC, Pinnock H. Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. Lancet. 2017;390:S32. doi:10.1016/s0140-6736(17)32967-7
26. Tang Y, Soh KL, Gan WY, Zhou J, Soh KG. The efficacy of PRECEDE-PROCEED model-based interventions on HbA1c and self-management in type 2 diabetes patients: a systematic review and meta-analysis. BMC Public Health. 2025;25(1):ahead of print. doi:10.1186/s12889-025-23073-9
27. Pamungkas RA, Chamroonsawasdi K. HbA1c reduction and weight-loss outcomes: a systematic review and meta-analysis of community-based intervention trials among patients with type 2 diabetes mellitus. Int J Diabetes Dev Ctries. 2019;39(2):394-407. doi:10.1007/s13410-018-0708-0
28. Alaofè H, Asaolu I, Ehiri J, et al. Community Health Workers in Diabetes Prevention and Management in Developing Countries. Ann Glob Heal. 2017;83(3-4):661-675. doi:10.1016/j.aogh.2017.10.009
29. Evans J, Ha H, White PT. Evaluating the effectiveness of community health worker interventions on glycaemic control in type 2 diabetes mellitus: a systematic review and meta-analysis. BMJ Open . 2025;15(7). doi:10.1136/bmjopen-2024-096651
Authors
Tangnga, M., Rekawati, E. ., & Rachmawati, U. (2026). Effectiveness of self-management intervention in community on management of type 2 diabetes mellitus: a systematic review. JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, 18(1), 33–41. https://doi.org/10.34011/juriskesbdg.v18i1.2971
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