Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: a systematic review and meta-analysis

Abstract

ObjectsThis study aims to systematically evaluate the effectiveness of nurse-led cares on cardiovascular risk factors among individuals with type 2 diabetes mellitus.DesignSystematic review and meta-analysis.MethodsThe electronic databases PubMed, EMBASE, CINAHL and Cochrane Library databases were searched for randomised controlled trials of nurse-led care for individuals with type 2 diabetes mellitus (T2DM) published in English from inception to 23 December 2021. Random effects models were used to calculate weighted mean differences (WMD) with 95%CI.Results13 articles were included in the meta-analysis, with a total of3757 participants. Considering baseline measurements, pooled analysis showed that nurse-led care significantly decreased the glycosylated haemoglobin (HbA1c) (WMD=−0.68 mmol/L; 95% CI −0.85 to –0.52; p<0.001), body mass index (BMI) (WMD=−0.54 kg/m2; 95% CI: −0.97 to –0.11; p=0.01) and systolic blood pressure (SBP) (WMD=−1.17 mmHg; 95% CI: −2.11 to –0.22; p=0.02) for patients with T2DM. But there was no difference in low-density lipoprotein cholesterol (LDL-c) (WMD=−2.50 mg/dL ; 95% CI: −5.07 to 0.08; p=0.06) between the nurse-led and control groups.ConclusionNurse-led care is an effective and accessible intervention that could improve HbA1c, SBP, BMI levels among individuals with T2DM.PROSPERO registration numberCRD42021248275.