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
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.