ReviewBMJ public health2026
Power Within: a meta-analysis of the roles of self-efficacy in type 2 diabetes self-care and glycaemic control.
Review in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Self-efficacy is a critical psychological factor in managing type 2 diabetes (T2D), yet findings across populations and measurement tools remain inconsistent. This meta-analysis investigates the associations between self-efficacy, self-care behaviours and glycaemic control (HbA1c), accounting for diabetes duration, geographic region and the type of self-efficacy scale used. A systematic search of six databases from 2007 to 2024 identified studies examining self-efficacy in relation to self-care and HbA1c in adults with T2D. Random effects models were used to pool data from 62 studies (n=19 231). Subgroup analyses explored differences by diabetes duration, global region, and measurement tool. Heterogeneity was assessed using I² and τ² statistics. Publication bias was evaluated using funnel plots, Egger's test and the trim-and-fill method. Self-efficacy was significantly associated with better self-care behaviour (r=0.44; 95% CI 0.36 to 0.51, p<0.001) and lower HbA1c (r=-0.27; 95% CI -0.37 to -0.17, p<0.001). Diabetes-specific self-efficacy measures yielded the strongest correlation with self-care (r=0.50; 95% CI 0.40 to 0.59). Stronger associations were observed in participants with shorter diabetes duration (r=0.51) and in low-income countries in East Asia (HbA1c: r=-0.34; 95% CI -0.49 to -0.17). Egger's test showed no significant publication bias (p=0.21). Sensitivity and subgroup analyses confirmed the robustness of findings despite high heterogeneity. Self-efficacy is consistently linked to improved self-care and HbA1c in T2D. Targeted interventions that enhance diabetes-specific self-efficacy, particularly early in the disease and in low-resource settings, may significantly improve diabetes outcomes globally. PROSPERO registration number CRD42024595997.
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