Efficacy of Nurse‐Led Digitalized Diabetes Management Program for Community‐Dwelling Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta‐Analysis

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Abstract
Purpose: Despite evidence supporting nurse‐led digitalized diabetes interventions, gaps persist in understanding their specific impact on community‐dwelling patients with type 2 diabetes mellitus (T2DM). Prior reviews lacked a quantitative synthesis of these interventions' effects on outcomes like self‐care, HbA1c, and quality of life (QoL), limiting their applicability to clinical practice. This study aimed to systematically evaluate and quantify the effectiveness of nurse‐led digitalized diabetes management programmes for community‐dwelling adults with T2DM. Methods: We searched six databases to identify relevant articles from their inception to June 2024. Randomized controlled trials that evaluate the effects of nurse‐led digitalized diabetes management programs for community‐dwelling patients with T2DM were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise the included studies. The pairwise meta‐analysis was performed through the software Comprehensive Meta‐Analysis Version 3.0. Results: Eleven RCTs were included, encompassing 2943 participants from various regions. Nurse‐led digitalized programs significantly improved self‐care behaviors (SMD = 1.15; 95% CI: 0.49 to 1.81), and QoL (SMD = 0.65; 95% CI: 0.37 to 0.94). The interventions also demonstrated a clinically meaningful reduction in HbA1c levels (MD = ‐0.25%; 95% CI: −0.43 to −0.06), highlighting their potential in improving glycaemic control. Heterogeneity across studies was substantial for self‐care but moderate for HbA1c and QoL. Conclusions: Nurse‐led digitalised diabetes management programmes effectively enhance self‐care behavior, reduce HbA1c levels, and improve QoL among community‐dwelling patients with T2DM. These findings underscore the potential of digitalised interventions as scalable and accessible alternatives to traditional diabetes management, particularly in non‐institutionalized settings. Clinical Relevance: Nurse‐led digitalised diabetes management programmes can empower community‐dwelling patients with T2DM to achieve better health outcomes by enhancing self‐care and glycaemic control while improving QoL. Their integration into routine clinical practice could address barriers to care, optimize diabetes management, and reduce the long‐term burden of the disease. Review Registration: The International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42024594874
Funding Information
  • Universitas Airlangga (318/UN3.LPPM/PT.01.03/2024)

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