{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:16:31Z","timestamp":1792887391126,"version":"4.5.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes Self-Management Education (DSME) is a cornerstone strategy for improving glycemic control, yet its clinical effectiveness is often limited by suboptimal adherence. The aim of this study is to evaluate through meta-analysis the impact of nurse-led DSME on glycemic control, lipid profiles, and self-efficacy in adults with type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA 2020 guidelines, we systematically searched PubMed, EMBASE, and Web of Science databases (up to February 28, 2025). Inclusion criteria comprised: randomized controlled trials (RCTs) comparing nurse-led DSME (\u22653 structured sessions) vs. usual care or other non-nurse-led interventions. Risk of bias was assessed using Cochrane RoB 2.0. Effect sizes [mean difference (MD) or standardized mean difference (SMD)] were pooled using R meta package with random-effects models (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      &amp;gt; 50%). Subgroup analyses and meta-regression were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight RCTs (reporting HbA1c outcomes) were included. Meta-analysis demonstrated: (1) Glycemic control: nurse-led DSME significantly reduced HbA1c at 4\u20136 months (MD = \u22120.92, 95% CI: \u22121.44 to \u22120.41) and &amp;gt;6 months (MD = \u22120.54, 95% CI: \u22120.86 to \u22120.23;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05), but not at 0\u20133 months (MD = \u22120.22, 95% CI: \u22121.15 to 0.51). Fasting blood glucose (FBG) showed significant improvement (MD = \u22120.20, 95% CI: \u22120.36 to \u22120.03). (2) Self-efficacy: the intervention group demonstrated significantly enhanced self-efficacy (SMD = 1.48, 95% CI: 1.04\u20131.92). (3) Lipid profiles: high-density lipoprotein (HDL) increased significantly (MD = 0.27, 95% CI: 0.14\u20130.41), while total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) showed no significant changes. (4) Considerable heterogeneity was observed (HbA1c:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 87.8%; self-efficacy:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 84.5%). Meta-regression suggested borderline significant influence of follow-up duration on effect size (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.059). No significant publication bias was detected (Egger's test\n                      <jats:italic>p<\/jats:italic>\n                      = 0.116).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nurse-led DSME effectively improves long-term glycemic control and self-efficacy while elevating HDL levels in T2DM patients, though standardization of intervention protocols is needed to reduce heterogeneity. This study supports integrating nurse-led models into diabetes management guidelines and recommends future research focus on long-term follow-up and cost-effectiveness analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/doi.org\/10.37766\/inplasy2025.7.0114<\/jats:ext-link>\n                      , identifier: NPLASY202570114.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1622988","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T05:23:57Z","timestamp":1754889837000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Impact of nurse-led self-management education on type 2 diabetes: a 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