Self-care practices in diabetes among populations in India: a systematic review and meta-analysis

Abstract

Introduction: Diabetes mellitus is a chronic condition that requires consistent self-management to prevent complications and maintain quality of life. This meta-analysis estimated the pooled prevalence of various self-care components in Indian populations with diabetes and their regional distribution. Methods: A literature search was conducted for studies published between January 2014 and November 2024 in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar. Studies reporting prevalence of various self-care practices among diabetic populations in India were included. Data was extracted based on study details, demographics, setting, and self-care practices. Study quality and bias risk were assessed using the Newcastle-Ottawa Scale. Statistical analysis was done in Stata version 18. A mixed method model was used to estimate the pooled prevalence. Heterogeneity was explored through sub-group analysis, sensitivity analysis and meta-regression. Results: A total of 29 articles were included in this review with 7863 populations. Most studies belonged to southern India (n = 19, 65.5%), and community settings (n = 15, 51.7%). The pooled prevalence of drug adherence was highest (71%, 95% CI: 63–79). This was followed by glucose monitoring (60, 50–70), dietary compliance (51, 42–59), healthy coping (43, 22–63), physical activity (41, 34–47), risk reduction (28, 20–36), and problem solving (22, 12–33). Meta-regression showed that the prevalence of physical activity is notably higher in the West (1.02, 95% CI: 0.57–1.48), East (0.77, 0.36–1.18), North (0.78, 0.36–1.18), and South (0.65, 0.31–1.0) regions compared to Central region. Glucose monitoring was significantly higher in East (0.7, 0.2–1.2) and South (0.57, 0.15–1.0) regions compared to Central region. Conclusion: Self-care practices among diabetic populations in India remain suboptimal, with considerable variation across regions. These findings underscore the urgent need for context-specific, scalable interventions and strengthened health system support to promote comprehensive diabetes self-management across the country.