Culturally Tailored Education Interventions to Enhance Diabetes Self-Management: A Systematic Review of Randomised Controlled Trials

Background: Cultural disparities in type 2 diabetes mellitus (T2DM) care contribute to suboptimal self-management and poor glycemic outcomes among ethnic minority populations. Culturally tailored diabetes self-management education and support (DSMES) interventions have emerged as a strategy to improve disease outcomes by aligning educational content with patients' beliefs, language, and traditional practices. This systematic review evaluates the effectiveness and core cultural components of culturally adapted DSMES interventions. Methods: A systematic search was conducted in PubMed, Scopus, EBSCOhost, and Taylor & Francis using PRISMA 2020 guidelines. Randomized controlled trials (RCTs) involving culturally tailored DSMES for adults with T2DM were included. Study quality was appraised using the Joanna Briggs Institute (JBI) checklist. Data were extracted and synthesized narratively. Results: A total of 14 high-quality RCTs met the inclusion criteria, representing diverse cultural groups including Latino, Black-British, Chinese, Pakistani immigrant, Iranian, and Korean American populations. Interventions incorporated culture through native-language delivery, traditional dietary guidance, family and community engagement, and culturally aligned behavioral support delivered via (I) traditional face-to-face or (II) technology-based interventions. Across the included studies, culturally tailored interventions were associated with statistically significant improvements in several diabetes self-management outcomes, including self-management behaviors, self-efficacy, diabetes knowledge, and psychosocial well-being, in many intervention groups compared with controls. Clinical outcomes also improved in several trials, most notably through significant reductions in HbA1c levels. Conclusion: Culturally tailored DSMES effectively enhances both behavioural and clinical outcomes in ethnically diverse populations with T2DM. Integrating cultural values, traditional diet, language, and community support strengthens patient engagement and optimizes the intervention's impact. Future studies should emphasise long-term follow-up, cost-effectiveness evaluation, and standardized reporting of cultural adaptation components to support wider implementation and scalability.