Systematic Review and Meta-Analysis of Good Self-Care Practice among People Living with Type 2 Diabetes Mellitus in Ethiopia: A National Call to Bolster Lifestyle Changes

Baye Dagnew, Getu Debalkie Demissie, Dessie Abebaw Angaw, Baye Dagnew, Getu Debalkie Demissie, Dessie Abebaw Angaw

Abstract

Background: Self-care practice is the mainstay of management for good glycemic control. Despite the presence of a few pocket studies, no comprehensive study was conducted in Ethiopia to demonstrate the overall good self-care practice among diabetic patients in Ethiopia. Therefore, we intended to conduct this systematic review and meta-analysis to estimate the overall good self-care practice among people living with type 2 diabetes mellitus (T2DM) in Ethiopia.

Methods: We systematically searched PubMed, Scopus, Science Direct, Cochrane library, Google scholar, and direct Google to retrieve relevant studies. Forest plot was used to present the pooled estimate of good self-care practice using DerSimonian and Laird's random-effects model. We checked publication bias using Egger's test and funnel plot. Potential heterogeneity was tested using the I-squared statistic. Moreover, subgroup and sensitivity analyses were performed.

Results: In this review, 12 primary studies (with a total sample size of 4030) were included. Because of the presence of heterogeneity, we employed a random-effects model. After running the random-effects model, the pooled estimate of overall good self-care practice was 51.12% (95% CI: 41.90-60.34). Furthermore, the pooled estimate of good dietary practice was 50.18% (95% CI: 32.75-67.60), good physical exercise practice was 48.29% (95% CI: 34.14-62.43), the good footcare practice was 63.61% (95% CI: 45.56-81.66), and appropriate self-monitoring of the blood glucose level was 31.89% (95% CI: -4.62-68.41). In this meta-analysis, there was serious interstudy variation, but there was no publication bias.

Conclusions: The overall good self-care practice among people living with T2DM was low which necessitates the need for designing strategies to increase the self-care practice. The health sector has to bolster awareness creation to allow better plasma glucose control and preventing diabetes-related complications. This trial is registered with CRD42019147694.

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Copyright © 2021 Baye Dagnew et al.

Figures

Figure 1
Figure 1
A PRISMA flow diagram exemplifying the study selection process of included studies for systematic review and meta-analysis of good self-care practice among people living with T2DM.
Figure 2
Figure 2
Estimated pooled prevalence of overall good self-care practice among T2DM.
Figure 3
Figure 3
Funnel plot to show publication bias for the good self-care practice.
Figure 4
Figure 4
Sensitivity analysis for studies included in the meta-analysis of overall good self-practice.
Figure 5
Figure 5
Estimated pooled prevalence of good dietary practice among T2DM.
Figure 6
Figure 6
Forest plot depicting good physical exercise among T2DM.
Figure 7
Figure 7
Pooled estimate of good footcare practice among people living with T2DM.
Figure 8
Figure 8
Pooled estimate of appropriate self-monitoring of the blood glucose level among T2DM.

References

    1. Guariguata L., Whiting D. R., Hambleton I., Beagley J., Linnenkamp U., Shaw J. E. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice. 2014;103(2):137–149. doi: 10.1016/j.diabres.2013.11.002.
    1. Wild S., Roglic G., Green A., Sicree R., King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–1053. doi: 10.2337/diacare.27.5.1047.
    1. Harries A. D., Satyanarayana S., Kumar A. M. V., et al. Epidemiology and interaction of diabetes mellitus and tuberculosis and challenges for care: a review [Review article] Public Health Action. 2013;3(1):3–9. doi: 10.5588/pha.13.0024.
    1. da Rocha Fernandes J., Ogurtsova K., Linnenkamp U., et al. IDF Diabetes Atlas estimates of 2014 global health expenditures on diabetes. Diabetes Research and Clinical Practice. 2016;117:48–54. doi: 10.1016/j.diabres.2016.04.016.
    1. Whiting D. R., Guariguata L., Weil C., Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice. 2011;94(3):311–321. doi: 10.1016/j.diabres.2011.10.029.
    1. Feleke Y., Enquselassie F. An assessment of the health care system for diabetes in Addis Ababa, Ethiopia. Ethiopian Journal of Health Development. 2005;19(3):203–210. doi: 10.4314/ejhd.v19i3.9999.
    1. Narayan K. V., Zhang P., Kanaya A. M., et al. Diabetes: The Pandemic and Potential Solutions. Disease Control Priorities in Developing Countries. 2nd. Chennai, India: The International Bank for Reconstruction and Development/The World Bank; 2006.
    1. Figueira A. L. G., Boas L. C. G. V., Coelho A. C. M., Freitas M. C. Fd, Pace A. E. Educational interventions for knowledge on the disease, treatment adherence and control of diabetes mellitus. Revista latino-americana de enfermagem. 2017;25 doi: 10.1590/1518-8345.1648.2863.
    1. Atlas I. D. Online Version of IDF Diabetes Atlas. Brussels, Belgium: International Diabetes Federation; 2013.
    1. Educators A. A. AADE guidelines for the practice of diabetes self-management education and training (DSME/T) The Diabetes Educator. 2009;35(3_suppl):85S–107S. doi: 10.1177/0145721709352436.
    1. Song M. Diabetes mellitus and the importance of self-care. Journal of Cardiovascular Nursing. 2010;25(2):93–98. doi: 10.1097/jcn.0b013e3181c5a364.
    1. Osborn C. Y., Bains S. S., Egede L. E. Health literacy, diabetes self-care, and glycemic control in adults with type 2 diabetes. Diabetes Technology & Therapeutics. 2010;12(11):913–919. doi: 10.1089/dia.2010.0058.
    1. Tshiananga J. K. T., Kocher S., Weber C., Erny-Albrecht K., Berndt K., Neeser K. The effect of nurse-led diabetes self-management education on glycosylated hemoglobin and cardiovascular risk factors. The Diabetes Educator. 2012;38(1):108–123. doi: 10.1177/0145721711423978.
    1. Hamasaki H. Daily physical activity and type 2 diabetes: a review. World Journal of Diabetes. 2016;7(12):p. 243. doi: 10.4239/wjd.v7.i12.243.
    1. Eva J. J., Fen N. C., Ming L. C., Yen W. Y., Sarker P., Rahman M. M. Self-care and self-management among adolescent T2DM patients: a focused review. Frontiers in Endocrinology. 2018;9:p. 489. doi: 10.3389/fendo.2018.00489.
    1. Welch V., Petticrew M., Tugwell P., et al. PRISMA-Equity 2012 extension: reporting guidelines for systematic reviews with a focus on health equity. PLoS Medicine. 2012;9(10) doi: 10.1371/journal.pmed.1001333.e1001333
    1. Hoy D., Brooks P., Woolf A., et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. Journal of Clinical Epidemiology. 2012;65(9):934–939. doi: 10.1016/j.jclinepi.2011.11.014.
    1. Federation I. D. IDF Diabetes Atlas: International Diabetes Federation. Chennai, India: Executive Office; 2011.
    1. Hailu E., Mariam W. H., Belachew T., Birhanu Z. Self-care practice and glycaemic control amongst adults with diabetes at the Jimma University Specialized Hospital in south-west Ethiopia: a cross-sectional study. African Journal of Primary Health Care & Family Medicine. 2012;4(1) doi: 10.4102/phcfm.v4i1.311.
    1. Demilew Y. M., Alem A. T., Emiru A. A. Dietary practice and associated factors among type 2 diabetic patients in felege hiwot regional referral hospital, Bahir dar, Ethiopia. BMC Research Notes. 2018;11(1):p. 434. doi: 10.1186/s13104-018-3531-2.
    1. Benjamin E. M. Self-monitoring of blood glucose: the basics. Clinical Diabetes. 2002;20(1):45–47. doi: 10.2337/diaclin.20.1.45.
    1. Higgins J. P. T., Thompson S. G., Deeks J. J., Altman D. G. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560. doi: 10.1136/bmj.327.7414.557.
    1. DerSimonian R., Laird N. Meta-analysis in clinical trials. Controlled Clinical Trials. 1986;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2.
    1. Abate T. W., Tareke M., Tirfie M. Self-care practices and associated factors among diabetes patients attending the outpatient department in Bahir Dar, Northwest Ethiopia. BMC Research Notes. 2018;11(1):p. 800. doi: 10.1186/s13104-018-3874-8.
    1. Asmelash D., Abdu N., Tefera S., Baynes H. W., Derbew C. Knowledge, attitude, and practice towards glycemic control and its associated factors among diabetes mellitus patients. Journal of Diabetes Research. 2019;2019:9. doi: 10.1155/2019/2593684.2593684
    1. Ayele B. H., Mengesha M. M., Tesfa T. Predictors of self-care activities of outpatient diabetic residents in Harar and Dire Dawa: a hospital-based cross-sectional study. SAGE Open Medicine. 2019;7 doi: 10.1177/2050312119865646.
    1. Ayele K., Tesfa B., Abebe L., Tilahun T., Girma E. Self care behavior among patients with diabetes in Harari, Eastern Ethiopia: the health belief model perspective. PLoS One. 2012;7(4) doi: 10.1371/journal.pone.0035515.e35515
    1. Berhe K. K., Gebru H. B., Kahsay H. B., Kahsay A. A. Assessment of self care management and its associated factors among type 2 diabetes patients in mekelle hospital and ayder referral hospitals, mekelle city, tigray, northern Ethiopia, 2012/13. Global Journal of Medical Research. 2017;17
    1. Chali S. W., Salih M. H., Abate A. T. Self-care practice and associated factors among diabetes mellitus patients on follow up in benishangul Gumuz regional state public hospitals, western Ethiopia: a cross-sectional study. BMC Research Notes. 2018;11(1):p. 833. doi: 10.1186/s13104-018-3939-8.
    1. Dedefo M. G., Ejeta B. M., Wakjira G. B., Mekonen G. F., Labata B. G. Self-care practices regarding diabetes among diabetic patients in West Ethiopia. BMC Research Notes. 2019;12(1):p. 212. doi: 10.1186/s13104-019-4258-4.
    1. Yohannes Addisu Endalew Hailu A. E. Assessment of diabetic patient perception on diabetic disease and self-care practice in dilla university referral hospital, south Ethiopia. Journal of Metabolic Syndrome. 2013;3(4) doi: 10.4172/2167-0943.1000166.
    1. Kassahun T., Gesesew H., Mwanri L., Eshetie T. Diabetes related knowledge, self-care behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: a cross-sectional survey. BMC Endocrine Disorders. 2016;16(1) doi: 10.1186/s12902-016-0114-x.
    1. Mamo M., Demissie M. Self care practice and its associated factors among diabetic patients in addisababa public hospitals, cross sectional study. Journal of Diabetes and Cholesterol Metabolism. 2016;1(1):2–5.
    1. Mariye T., Tasew H., Teklay G., Gerensea H., Daba W. Magnitude of diabetes self-care practice and associated factors among type two adult diabetic patients following at public Hospitals in central zone, Tigray Region, Ethiopia, 2017. BMC Research Notes. 2018;11(1):p. 380. doi: 10.1186/s13104-018-3489-0.
    1. Sorato M. M. Levels and predictors of adherence to self-care behaviour among adult type 2 diabetics at arba minch general hospital, Southern Ethiopia. Journal of Diabetes & Metabolism. 2016;7(6) doi: 10.4172/2155-6156.1000684.
    1. Shrivastava S. R., Shrivastava P. S., Ramasamy J. Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders. 2013;12(1):p. 14. doi: 10.1186/2251-6581-12-14.
    1. Tol A., Shojaeezadeh D., Eslami A., et al. Evaluation of self-care practices and relative components among type 2 diabetic patients. Journal of Education and Health Promotion. 2012;1 doi: 10.4103/2277-9531.102048.
    1. Organization W. H. Self-care in the Context of Primary Health Care. New Delhi, India: WHO Regional Office for South-East Asia; 2009.
    1. Roglic G. WHO Global report on diabetes: a summary. International Journal of Noncommunicable Diseases. 2016;1(1):p. 3. doi: 10.4103/2468-8827.184853.
    1. Tan M. Y., Magarey J. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Patient Education and Counseling. 2008;72(2):252–267. doi: 10.1016/j.pec.2008.03.017.
    1. Saleh F., Mumu S. J., Ara F., Hafez M. A., Ali L. Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study. BMC Public Health. 2014;14(1):p. 431. doi: 10.1186/1471-2458-14-431.
    1. Osei-Yeboah J., Owiredu W., Norgbe G., et al. Physical activity pattern and its association with glycaemic and blood pressure control among people living with diabetes (PLWD) in the Ho municipality, Ghana. Ethiopian Journal of Health Sciences. 2019;29(1)
    1. ALhariri A., Daud F., Saghir S. A. M. Factors associated with adherence to diet and exercise among type 2 diabetes patients in Yemen. Diabetes Management. 2017;7(3):264–271.
    1. .
    1. Mohammed M. A., Sharew N. T. Adherence to dietary recommendation and associated factors among diabetic patients in Ethiopian teaching hospitals. Pan African Medical Journal. 2019;33(260) doi: 10.11604/pamj.2019.33.260.14463.
    1. Worku A., Abebe S. M., Wassie M. M. Dietary practice and associated factors among type 2 diabetic patients: a cross sectional hospital based study, Addis Ababa, Ethiopia. SpringerPlus. 2015;4(1):p. 15. doi: 10.1186/s40064-015-0785-1.
    1. Muhammad-Lutfi A., Zaraihah M., Anuar-Ramdhan I. Knowledge and practice of diabetic foot care in an in- patient Setting at a tertiary medical center. Malaysian Orthopaedic Journal. 2014;8(3):p. 22. doi: 10.5704/moj.1411.005.
    1. Saber H. J., Daoud A. S. Knowledge and practice about the foot care and the prevalence of the neuropathy among a sample of type 2 diabetic patients in Erbil, Iraq. Journal of Family Medicine and Primary Care. 2018;7(5):p. 967.
    1. Lakshmi N., Patel N., Parmar P., Garasiya K., Chaudhary M. Study the foot care practice among diabetic patients in Ahmedabad city, Gujarat. International Journal of Medical Science and Public Health. 2018;7(5):333–338. doi: 10.5455/ijmsph.2018.0204407022018.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir