OBJECTIVE: We conducted a systematic review and meta-analysis of insulin education for people with type 2 diabetes to assess its effectiveness in improving glycaemic levels.
METHODS: We searched the following online databases from the earliest record to 17 February 2020: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of science, Cochrane Library and https://clinicaltrials.gov. Data was extracted on publication status, participants' characteristics at baseline, intervention and control group, study design, and data for primary and secondary outcomes, change in HbA1c(%), change in weight (Kilogram). The review was registered with international prospective register of systematic reviews registration (PROSPERO):CRD42020167769.
RESULTS: Eighteen papers were included in the systematic review. In the meta-analysis there was a small statistically significant improvement in HbA1c (0.39% points/4.4 mmol/mol reduction) in the insulin education group compared to control conditions (N = 10 studies, n = 3307 participants, SMD = -0.22, 95% CI = -0.34, -0.10, I2 = 66% p = 0.002). There was a small non-significant increase in weight (0.54 Kg) in the insulin education group compared to control conditions (N = 6 studies, n = 470 participants, SMD = 0.03, 95% CI = -0.10, 0.17, I2 = 0.0%, p = 0.82). Quality of evidence was rated low to very low.
CONCLUSIONS: Enhanced insulin education delivered by diabetes specialists is potentially more effective than standard care. Further research is required to reach robust conclusions.