An Integrative Model of Self-Regulation in Type 2 Diabetes Self-Management: A Systematic Review of Individual and Family-Based Interventions

Abstract

<b>Background/Objectives:</b> Self-care is essential in managing type 2 diabetes (T2DM), yet it remains suboptimal among patients. This systematic review aimed to determine whether self-regulation-based self-management interventions improve glycemic control, self-efficacy, and quality of life among adults with type 2 diabetes mellitus (T2DM), including individual and family-based approaches. <b>Methods:</b> Four major databases (Scopus, ScienceDirect, ProQuest, and PubMed) were systematically searched for English-language studies following PRISMA guidelines. Screening was performed using Rayyan, and study quality was assessed with the JBI critical appraisal tool. Data were synthesized based on PICO outcomes and study design to identify key patterns. The review was registered in PROSPERO (CRD42024594398). <b>Results:</b> A total of 881 articles were identified, and 31 met the inclusion criteria. Most studies were randomized controlled trials (54.8%), with diabetes self-management education (DSME) being the most common intervention (41.9%), followed by self-regulation training (12.9%). Nearly half of the studies measured blood glucose and quality-of-life outcomes (22.6%), while others focused on knowledge, behavior, and self-efficacy (19.4%). Only a few studies addressed individual and family-oriented interventions. <b>Conclusions:</b> DSME and self-regulation-based approaches are recommended as complementary strategies to improve diabetes self-management. This review introduces a novel integrative model linking disease interpretation, coping strategies, and family support, and highlights their influence on patient self-care behaviors. Future research should empirically test this model to clarify the dynamic interactions among its domains and their effects on glycemic control and health outcomes.

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