Educational interventions for migrant South Asians with Type 2 diabetes: a systematic review

To conduct a systematic review to determine the scope of published assessments of educational initiatives for South Asians with Type 2 diabetes living in Western countries and to consider the effectiveness of reported interventions.

A range of electronic databases was searched using Medical Subject Headings (MeSH) and free text terms; papers published up to the end of 2007 were considered. Two researchers independently reviewed titles and abstracts and the full text of selected citations. Reference list review and consultation with experts in the field were used to check for completeness of the final sample of studies prior to data extraction.

Only nine studies, including five randomized controlled trials with a combined total of 1004 cases, met our inclusion criteria. The quality of reporting in some studies was limited, e.g. omission of detailed information about ethnicity. Selected studies included a range of group and one-to-one interventions with varied knowledge, psychological and biomedical outcome measures. The effectiveness of the interventions was also variable, and the low number and heterogeneity of the studies made identification of factors linked to effectiveness difficult and meta-analysis inappropriate. However, it appeared that improvements in knowledge levels may be easier to achieve than positive biomedical outcomes, and the need for tailored approaches was suggested.

Our findings confirm the difficulty of designing, assessing and achieving an impact through educational interventions for migrant South Asians with Type 2 diabetes and emphasize the need for good-quality studies in these high-risk populations.