Effectiveness of Diabetes Self-Management Education and Support Interventions on Glycemic Levels Among People Living with Type 2 Diabetes in the WHO African Region: A Systematic Review and Meta-Analysis.

Abstract

This systematic review and meta-analysis evaluated the effectiveness of Diabetes Self-Management Education and Support (D-SMES) interventions on glycemic control among adults with type 2 diabetes in the World Health Organization (WHO) African Region. Given the region's high and growing burden of diabetes, alongside mixed evidence on the impact of self-management support, this study synthesized data from randomized controlled trials comparing D-SMES to usual care. A comprehensive search of databases including PubMed, CINAHL, and the Cochrane Library was conducted up to May 2025. The analysis included 19 studies with a total of 3,759 participants. The meta-analysis revealed a statistically significant, moderate effect of D-SMES interventions in reducing glycated hemoglobin (HbA1c) levels, with a pooled standard mean difference of -0.468 (95% CI: -0.658 to -0.279). The majority of included studies were assessed as having a low risk of bias. The study concludes that D-SMES interventions are moderately effective in improving glycemic control in this population, supporting their strategic implementation within routine diabetes care across the WHO African Region to help address the public health challenge of type 2 diabetes.