Nurse-Led Interventions for Diabetes Education: A Literature Review


  • Rif’atunnailah Mat Isa Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Medical Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia;.
  • Mei Chan Chong Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  • Wan Ling Lee Department of Nursing, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
  • Tajunisah Begam Mohamed Iqbal Department of Opthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
  • Sumaiyah @ Thandar Soe Jamaludin Department of Medical Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Pahang, Malaysia
  • Mohd Iman Saiful Suhardi Department of Emergency Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia.



Nurses-led interventions, Diabetes mellitus, Diabetes retinopathy


Background: The incidence of blindness is escalating to 439 billion patients by 2030. This study aims to review studies of health education related to diabetic retinopathy that have been implemented to inform nurse-led intervention to patients with type 2 diabetes mellitus (T2DM).

Methods: A comprehensive search of the database was performed from October 2021 until March 2022. The databases include CINAHL, EMERALD insight, SAGE, Scopus, Web of Science and Science Direct. The Medical Subject Headings database was used to derive the following keywords: ‘T2DM' OR ‘Diabetes Mellitus type 2’, Diabetic Retinopathy’ OR ‘Diabetic eye’ OR ‘retinopathies') AND ‘education’, self-care’, ‘visual quality of life’, ‘mHealth’. All studies in English pertaining to the type of teaching and the effects of education on the visual quality of life among T2DM patients were included. Type 1 diabetes mellitus studies were excluded. Analysis of the themes arising from the results was performed.

Results: The search yielded 868 articles, of which 27 met our criteria. The studies ranged from cross-sectional, controlled studies, quasi-experimental studies, and qualitative studies. Overall, there was three types of health education interventions: personalised, group-based, and technology-based.

Conclusion: There is paucity in nurse-led health education about diabetic retinopathy in East Asia. It appears that conventional health education helpful, but the mobile application might be an option to provide better health education, with an emphasis on diabetic retinopathy components.


titioners fail to increase retinal screening among their patients with diabetes: a pragmatic cluster randomized controlled trial. Implementation Sci.2014;(9):87.

Debussche X, Besançon S, Balcou-Debussche M, et al. Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali. PLoS One.2018;13(1):e0191262.

van Puffelen AL, Rijken M, Heijmans MJWM, Nijpels G, Schellevis FG; Diacourse study group. Effectiveness of a self-management support program for type 2 diabetes patients in the first years of illness: Results from a randomized controlled trial. PLoS One.2019;14(6):e0218242. 10.1371/journal.pone.0218242.

Dong Y, Wang P. , Dai Z, Liu K, Jin Y, Li A, Wang S, Zheng J. Increased self-care activities and glycemic control rate in relation to health education via Wechat among diabetes patients: A randomized clinical trial. Medicine.2018; 97(50); e13632.DOI: 10.1097/MD.0000000000013632

Karahan OG & Ecevit A?. Effect of Web-based diabetes training program on diabetes-related knowledge, attitudes, and skills of health professionals: A randomized controlled trial. Japan Journal of Nursing Science. 2019; 16(2). doi:http://10.1111/jjns.12228.

Yu Y, Yan Q, Li H, et al. Effects of mobile phone application combined with or without self-monitoring of blood glucose on glycemic control in patients with diabetes: A randomized controlled trial. J Diabetes Investig. 2019;10(5):1365-1371. doi:10.1111/jdi.13031.

Tsui I, Drexler A, Stanton AL, Kageyama J, Ngo E & Straatsma BR. Pilot study using mobile health to coordinate the diabetic patient, diabetologist, and ophthalmologist. J Diabetes Sci Technol. 2014;8(4):845-849. doi:10.1177/1932296814529637.

Brazionis L, Jenkins A, Keech A, Ryan C, Bursell SE, & Group TES. An evaluation of the telehealth facilitation of diabetes and cardiovascular care in remote Australian Indigenous communities: - protocol for the telehealth eye and associated medical services network [TEAMSnet] project, a pre-post study design. BMC Health Services Research.2017;5(17), 13. doi: 10.1186/s12913-016-1967-4.

Skrzypecki J, Sta?ska K, & Grabska-Liberek I. Patient-oriented mobile applications in ophthalmology. Clinical & Experimental Optometry.2019;102(2):180. doi:10.1111/cxo.12830.

Yang L, Wu Q, Hao Y, et al. Self-management behavior among patients with diabetic retinopathy in the community: a structural equation model. Qual Life Res. 2017;26(2):359-366. doi:10.1007/s11136-016-1396-1.

Niroomand M, Ghasemi SN, Karimi-Sari H, Kazempour-Ardebili S, Amiri P & Khosravi MH. Diabetes knowledge, attitude and practice (KAP) study among Iranian in-patients with type-2 diabetes: A cross-sectional study. Diabetes Metab Syndr.2016; 10(1): 114-119. doi:10.1016/j.dsx.2015.10.00.

Fenwick EK, Xie J, Rees G, Finger RP, & Lamoureux EL. Factors Associated with Knowledge of Diabetes in Patients with Type 2 Diabetes Using the Diabetes Knowledge Test Validated with Rasch Analysis. PLoS ONE. 2018; 8(12). doi:

Ligda, Ploubidis D, Foteli S, Kontou PI, Nikolaou C & Tentolouris N. Quality of life in subjects with type 2 diabetes mellitus with diabetic retinopathy: A case–control study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; 13(2).

Xiaoting P, XY, Yingrui Y, Hongmei Z, Mengting X, Ranran H, Yuming W & Zhijie L. Efficacy of artificial intelligence-based screening for diabetic retinopathy in type 2 diabetes mellitus patients. Diabetic Research and Clinical Practice. 2022;184.

Piyasena MMPN, Murthy GVS, Yip JLY, Gilbert C, Peto T, Premarathna M, & Zuurmond M. A qualitative study on barriers and enablers to uptake of diabetic retinopathy screening by people with diabetes in the Western Province of Sri Lanka. Tropical Medicine & Health. 2019; 47(1).10.1186/s41182-019-0160-y.




How to Cite

Mat Isa, R., Chong, M. C., Lee, W. L., Mohamed Iqbal, T. B., Jamaludin, S. @ T. S., & Saiful Suhardi, M. I. (2023). Nurse-Led Interventions for Diabetes Education: A Literature Review. INTERNATIONAL JOURNAL OF CARE SCHOLARS, 6(3), 90–100.

Most read articles by the same author(s)