Effect of Diabetic Self-management Education (DSME) on Clinical, Psychosocial, and Behavioral Outcomes Among People With Type 2 Diabetes Attending Jimma University Medical Center (JUMC)

As incidence and prevalence of non-communicable chronic diseases (NCDs) is increasing, care of individuals with NCDs become challenging, complex and expensive (1). One of the models used for the management of NCDs is the mode developed by Wagner and his colleagues in 1990s. Of the six components of the model self-management support has been identified and customized to diabetic care which helps to assist diabetic patients to overcome attitudinal and motivational barriers, improve their self-management skills and feelings of self-efficacy (2).

The objective of DSME is to support the individual to make informed decision, cope with daily demands of diabetes, make behavioral changes that support their self-care practice, active collaboration with the health care team and improve clinical outcomes, health status, and quality of life (3, 4).

In some of developed countries, it was found that DSME is effective in reducing HbA1c, BGL, BP, BMI, anxiety, need for diabetes medication and risk of complications as well as improve diabetes knowledge, sound activity, diet, self-care practice, quality of life (5-8).

Though very few intervention studies related to DSME are conducted in a very few countries (9-12), the role of culture friendly DSME in Africa is not well understood. In addition, since Africa has a different living style, culture, belief, and probably different risk factors of diabetes as well, the effectiveness of DSME is not well understood and it has not been given a due attention. Similarly, in Ethiopia despite large number of people with diabetes, so far to our knowledge no organized DSME has been developed, tested and implemented.

Therefore, exploring effectiveness of DSME in Ethiopian context is paramount. The findings from this study can be important to help patients living with Diabetes 2 to leave healthier life by reducing/preventing the occurrence of complications. Moreover, it may initiate policy makers, health planners and other relevant stakeholders about importance of diabetes control using self-management education and support. At the same time, self-management is expected to contribute to improve clinical outcome, reduce risk factors, prevent or delay of disabilities and ultimately improve the quality of life for the individuals and their families. This may in turn enables societal members to participate in the country's economic growth and development. The findings of this study will also be used as a baseline for future related studies. The finding of the study can also be used as a starting point for the Ethiopian Federal Ministry of Health (FMoH) and the respective regional health bureaus to develop and implement culturally friendly DSME model. Moreover, it can initiate relevant bodies to design short-term and long-term curriculum for training of relevant front line health care providers, like nurses or community health workers, who will have a central role in the support of clients with diabetes.