Real-world completion of diabetes self management education and its impact on patient-reported outcomes: A scoping review

Published Date: 03rd April 2026

Publication Authors: Lewis. G

Abstract

Aims: Diabetes self management education (DSME) is recommended for type 2 diabetes, with completion widely accepted as ≥60% engagement. This review utilising PRISMA extension for scoping reviews maps the literature on the impact of full and partial completion of DSME on patient-reported outcomes (PROMs) versus a control.
Methods: Core search terms for type 2 diabetes were combined with DSME and PROMs (self care, diabetes distress and QOL) using the AND Boolean operator. Searches of CINAHL, MEDLINE and EMBASE 1 February, 2024, were checked September 2025. No restrictions were applied to study quality, location or sex. We examined quantitative studies comparing outcomes based on DSME completion [100%] vs. control [0%] vs. partial completion [1%-99%]. Studies employing ITT analyses or pre-post designs without controls were excluded to focus on outcomes by programme completion.
Results: Databases yielded 1307 records with an additional 12 through hand-searching key journals, reference lists and websites. Twenty-four records met inclusion criteria. No studies reported outcomes for partial DSME completion. Evidence suggests 100% DSME completion improves self management skills and QOL over 3-6 months, with greater gains in self care behaviours and mental health-related QOL. Medication adherence and physical health improved less consistently.
Conclusions: Evidence of short-term improvements in self management skills and QOL was constrained by programme heterogeneity, methodological variability and predominantly high-income settings. Evidence supporting sustained benefits beyond 6-12 months is limited and impact on diabetes distress is uncertain. No studies reported the effectiveness of partial completion of DSME on PROMs, despite a widely accepted benchmark suggesting ≥60% engagement constitutes completion.

Lewis, G.; Hardy, K.; Et al. (2026). Real-world completion of diabetes self management education and its impact on patient-reported outcomes: A scoping review. Diabetic Medicine, p.e70312. [Online]. Available at: https://doi.org/10.1111/dme.70312 [Accessed 9 April 2026].