Effectiveness of diabetes educational interventions in Iran: A systematic review

Background: Education of patients with diabetes is considered a fundamental aspect of diabetes care and aims to empower patients by improving knowledge and skills. The aim of this study was to conduct a systematic review of reports published about educational interventions on Iranian patients with diabetes. Methods: All published articles in Iranian and international journals and those presented in relevant congresses were reviewed using standard key words. Studies published from April 2002 to December 2008 that met the eligibility criteria were included for this systematic review. Results: A total of 18 discrete studies were identified. These studies were heterogeneous with respect to patient population, educational intervention, outcomes assessed, study quality, and generalizability. However, positive effects of self-management training on knowledge, frequency, and accuracy of self-monitoring of blood glucose and glycemic control were demonstrated in studies with short follow-up (less than 6 months). Effects of interventions on lipids, nutritional diet, weight, blood pressure, and quality of life were variable. Conclusions: There are insufficient and conflicting findings to obtain any firm conclusions regarding diabetes education in Iran. However, the appropriate diabetes health education appears to have short-term effects on glycemic control and knowledge of diabetes. The heterogeneity of studies made subgroup comparisons difficult to interpret with confidence. There is a need for long-term, more rigorous methodology. It is also highly recommended to health policy makers in Iran that a special course for training diabetes educators be designed because it would enable them to tailor appropriate education intervention for people with diabetes.