Systematic review and meta-analysis of diabetes specialist delivered insulin education for adults with type 2 diabetes in outpatient settings.

Abstract Objective We conducted a systematic review and meta-analysis of insulin education for people with type 2 diabetes to assess its effectiveness in improving glycaemic levels. Methods We searched the following online databases from the earliest record to 17 February 2020: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of science, Cochrane Library and https://clinicaltrials.gov . Data was extracted on publication status, participants’ characteristics at baseline, intervention and control group, study design, and data for primary and secondary outcomes, change in HbA1c(%), change in weight (Kilogram). The review was registered with international prospective register of systematic reviews registration (PROSPERO):CRD42020167769. Results Eighteen papers were included in the systematic review. In the meta-analysis there was a small statistically significant improvement in HbA1c (0.39% points/4.4 mmol/mol reduction) in the insulin education group compared to control conditions (N = 10 studies, n = 3307 participants, SMD = −0.22, 95% CI = −0.34, −0.10, I2 = 66% p = 0.002). There was a small non-significant increase in weight (0.54 Kg) in the insulin education group compared to control conditions (N = 6 studies, n = 470 participants, SMD = 0.03, 95% CI = −0.10, 0.17, I2 = 0.0%, p = 0.82). Quality of evidence was rated low to very low. Conclusions Enhanced insulin education delivered by diabetes specialists is potentially more effective than standard care. Further research is required to reach robust conclusions.