Self-care programmes helped insulin users at first, but results at six months were unclear.

The review

1. 01

   Who took part

   2,613 adults with type 2 diabetes took part in nine trials, and all of them used insulin injections. Their average age was about 56 to 65, and the trials were in six countries.

2. 02

   What they did

   Most programmes mixed teaching, skills practice and help with changing behaviour. Trained helpers, such as nurses or pharmacists, ran them in groups, one to one, or both, for five weeks to seven months. The other groups got usual care, standard teaching about diabetes or a different course.

3. 03

   What happened

   Right after the programmes, HbA1c fell by about 0.2 percentage points more than in the other groups, across six trials. Self-care and confidence also rose more, across two trials each. Six months later, self-care and HbA1c did not clearly differ, and some of the paper's counts do not match its trial sizes.

What the review found

1. HelpedOther outcomes

   Across six studies, the programmes lowered HbA1c, a blood sugar test, more than usual care did right after they ended.

   • Action: Learn how the problem workstested
   • Rule: With a coach or therapistused

   Pooled analysis of 6 studies with 1,890 people · vs people who got usual care or standard teaching · ⚠ whole programmes were tested, so no single part can be credited

2. HelpedGoals

   Across two studies, people said they did more self-care right after the programmes than after usual care.

   • Action: Set a specific goaltested
   • Action: Learn how the problem workstested
   • Rule: With a coach or therapistused

   Pooled analysis of 2 studies with 1,354 people · vs people who got usual care · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

3. HelpedMotivation

   Across two studies, people felt surer right after the programmes than after usual care.

   • Action: Set a specific goaltested
   • Rule: With a coach or therapistused

   Pooled analysis of 2 studies with 1,365 people · vs people who got usual care · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

4. No differenceGoals

   Across two studies, self-care did not differ from a different course six months later.

   • Action: Set a specific goaltested
   • Action: Learn how the problem worksused
   • Rule: With a coach or therapistused

   Pooled analysis of 2 studies with 327 people · vs people who took a different education course · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

Source