The Effectiveness of Diabetes Self-Management Education (DSME) Interventions on Glycemic Control, Self-Efficacy, and Quality of Life: A Systematic Review

Background: Diabetes Self-Management Education (DSME) is pivotal for patient empowerment and glycemic control. However, synthesized evidence evaluating diverse delivery modalities in low- and middle-income contexts remains dispersed.
Objectives: To systematically evaluate the effectiveness of DSME interventions on primary clinical outcomes (glycemic control/HbA1c, anthropometric parameters) and secondary psychosocial outcomes (self-efficacy, self-care adherence, and Health-Related Quality of Life [HRQoL]) across adult Type 2 Diabetes Mellitus (T2DM) populations.
Methods: A systematic review was conducted adhering to PRISMA 2020 guidelines. Comprehensive searches across PubMed, Scopus, CINAHL, and Google Scholar (2013–2025) identified empirical primary studies evaluating DSME. Quality and risk of bias were assessed using Cochrane RoB 2, ROBINS-I, and JBI appraisal tools. Due to substantial clinical and methodological heterogeneity, a structured narrative synthesis guided by the Synthesis Without Meta-analysis (SWiM) framework was executed.
Results: Twelve studies comprising randomized controlled trials (n=2), quasi-experimental designs (n=4), pre-experimental studies (n=2), pilot/case studies (n=3), and cross-sectional studies (n=1) were included (n=431 total participants across Indonesia [n=11] and Mali [n=1]). DSME interventions significantly improved glycemic control, with a 12-month peer-led RCT demonstrating a 1.05% HbA1c reduction (vs. 0.15% control, p < 0.05) alongside significant reductions in BMI (-1.65 kg/m²) and waist circumference (-3.34 cm). DSME consistently improved dietary compliance (increasing adherence from 18.7% to 81.3%, p = 0.006), self-efficacy (p = 0.001), and self-care behaviors (p = 0.000). Furthermore, DSME exhibited a strong positive association with high HRQoL (OR = 7.2, p = 0.002). Digital SMS, printed booklets, and structured community frameworks ('PASTI SEMBUH') proved highly effective.
Conclusions: DSME is a robust, highly adaptable intervention that drives clinical and behavioral improvements. Healthcare systems should prioritize structured, culturally tailored DSME integration into routine outpatient care.

Diabetes Self-Management Education (DSME), self-management practices, diabetes, systematic review, glycemic control

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