Table 1 Characteristics of included studies.

Shen³⁶

China

I:93/

C:96

I:18–75/

C:18–75

Personalized service package, with follow-up visits every 3 days before blood glucose levels are met, and monthly visits thereafter, for a total of 9 months

National Public Health Service Package Management

Led by the family doctor team, in collaboration with health nurses, nutritionists, and social (volunteer) workers, providing personalized diagnosis, treatment, and follow-up management

①②③④⑤⑥⑦

Ben²⁴

China

I:68/

C:69

I:58.92 ± 7.60/

C:59.18 ± 7.74

“Internet + ”Health Management Platform, weekly data upload and regular follow-ups, 12 months

Routine management

Family doctor team online (APP/WeChat interaction) combined with offline (on-site diagnosis and treatment), smart devices real-time monitoring data feedback

①②③④⑤⑥⑦⑧

Peng³⁴

China

I:54/

C:48

I:36–68/

C:36–68

Internet-based health education, including website video lectures (once/week), WeChat public account posts (2–3 times/week), and peer education groups (2–3 times/month), for a total of 6 months

Conventional health education

Multidisciplinary team (physicians, nurses, peer educators) combining online and offline approaches, providing personalized health guidance

①②③④⑤⑥⑦

Wang³⁷

China

I:60/

C:60

I:58.6 ± 6.3/

C:60.8 ± 7.4

Internet of Things Technology Management,portable blood glucose meter and cloud platform, 6 months

Routine diabetes management

Community doctor remote monitoring, smart device automatic reminders, online health guidance

①②③④⑤⑥⑦⑧

Huang²⁹

China

I:100/

C:100

I:59.25 ± 3.57/

C:59.29 ± 3.56

Traditional Chinese Medicine holistic management, 12 months

Conventional management

Integrated Chinese and Western Medicine team to develop personalized plans, focusing on overall balance and complication prevention

①②③⑦

Luo³³

China

I:60/

C:60

I:45 ~ 75/

C:45 ~ 75

Enhanced blood glucose monitoring by family doctors, weekly glucose testing at the studio for 6 months

Routine follow-up

One-on-one high-frequency monitoring by family doctors, combined with dietary and exercise guidance

①②③④⑤⑥⑦⑧

Zhang³⁹

China

I:72/

C:72

I:61.69 ± 8.02/

C:59.33 ± 8.34

Self-management group activities, once a week for 6 months

Routine management

Patient self-management group supported by community doctors, led by group leaders in learning and practice

①③④⑤⑥⑦⑧

Ren³⁵

China

I:53/

C:52

I:56.3 ± 15.0

C:57.1 ± 15.3

Family doctor individualized strategies, developing personalized plans, bi-weekly telephone follow-ups, monthly follow-ups for 6 months

Routine management

Family doctor team-led, one-on-one personalized management, developing plans based on patient lifestyle and condition

①②③

Liu³²

China

I:76/

C:68

I:18–75/

C:18–75

Peer support intervention (standardized diabetes management and peer support group activities) for 36 months

Standardized diabetes management

Community doctors train group leaders, patient-led group interactions (knowledge learning, experience sharing, problem-solving)

①③

Li³¹

China

I:123/

C:125

I:57–81/

C:57–81

Systematic self-management education (classroom education, once a month for the first 12 months; bi-monthly telephone follow-ups for the last 6 months), for 18 months

Routine community education

Multiform education combining (special lectures, group discussions, telephone follow-up support)

①②③

Li³⁰

China

I:60/

C:60

I:59.29 ± 15.4/

C:59.29 ± 15.4

Group interactive management (divided into 3 groups, with quarterly patient-patient/nurse-patient interaction sessions), lasting 18 months

Routine self-management

Specialist nurses organize group interactions, providing on-site guidance and personalized advice

①③

Fan²⁷

China

I:100/

C:100

I:63.5 ± 5.9/

C:63.6 ± 6.0

Family physician refined management (outpatient personalized guidance, quarterly HbA_1c monitoring), for 12 months

Traditional management (public health physician quarterly follow-up)

Family physician contract system, targeted health education and follow-up

①②③

Gong²⁸

China

I:179/

C:184

I:61.9 ± 7.1/

C:62.2 ± 9.2

Remote Blood Glucose Management System (Home glucose meter uploads data in real time, 4 times per week for the first 3 months, 2 times per week from 4 to 6 months, and once per week from 7 to 12 months)

Routine Blood Glucose

Management Community and tertiary hospital collaboration, remote real-time monitoring and SMS guidance

①③④⑤⑥⑦

Cai²⁵

China

I:500/

C:500

I:66.5 ± 6.4/

C:65.9 ± 6.5

Traditional Chinese Medicine (TCM) characteristic health education (syndrome differentiation and treatment + TCM dietary/exercise/psychological guidance), lasting 10 months

Conventional drug therapy and oral health education

Individualized intervention guided by TCM theory (syndrome differentiation, seasonal health maintenance, dietary regulation)

①②③④⑤⑥⑦⑧

Shen²⁶

China

I:150/

C:150

I:62.6 ± 10.2/

C:62.8 ± 10.5

The five-in-one approach of Traditional Chinese Medicine (TCM syndrome differentiation and constitution identification + health education + constitution regulation + meridian dredging + seasonal sequence), lasting 12 months

Regular family doctor contracted services

The family doctor team integrates TCM theory to provide syndrome differentiation treatment, seasonal health maintenance, medicinal diet regulation, and meridian therapy

①②③④⑤⑥⑦⑧

Yu³⁸

China

I:426/

C:394

I:67.62 ± 11.31

C:68.27 ± 12.47

Mobile healthcare APP intervention, blood glucose monitoring ≥ 3 times/day, ≥ 3 days/week, for 6 months;

Routine community intervention

Community doctors remotely monitor via APP, adjust medication and provide lifestyle guidance in real-time

①③⑦

Davies⁴⁰

UK

I:437/

C:387

I:59.9 ± 8.4

C:60.2 ± 8.7

Structured group education, emphasizing behavior change, medication management, etc., for 12 months

Routine care

Each site has a local coordinator to oversee the trial, with primary care institutions collaborating with the research team to ensure intervention consistency

①④⑤⑥⑦

Debussche⁴¹

Mali

I:70/

C:70

I:53.9 ± 9.8

C:51.1 ± 9.6

Peer-led structured patient education, 3 sessions, each consisting of 4 group meetings, totaling 12 months

Routine care

Community health workers: Train 5 peer educators to provide culturally tailored group education focusing on diet, exercise, blood glucose management, etc

①⑧

Deng⁵³

China

I:90/

C:97

I:56.34 ± 7.94

C:57.51 ± 5.96

Peer support training, with the first 3 months dedicated to traditional training and the subsequent 4 months to peer support, totaling 7 months

Traditional training and follow-up

Community nurses collaborate with peer supporters: nurses train peer supporters, providing personalized telephone consultations and group activities

①③④⑥⑦⑧

Jia⁴²

China

I:13,037/

C:6509

I:60.5 ± 8.4/

C:60.5 ± 8.4

mHealth stratified diabetes management intervention, including monthly blood glucose monitoring, quarterly performance evaluation, and mobile health platform support, lasting for 12 months

Routine care, basic public health services;

Tertiary hospital and community linkage: primary care physicians monitor in real-time through the mobile platform, with remote support provided by higher-level hospitals

①③⑥

Kim⁴³

USA

I:105/

C:104

I:58.7 ± 8.4/

C:58.7 ± 8.4

Multimodal intervention, 12-h group education and monthly telephone consultation, for a total of 12 months

Baseline education manual

Bilingual nurse and community health worker team: providing culturally tailored education, blood glucose monitoring guidance, and psychological support

①④⑤⑥⑦

Kong⁴⁴

China

I:134/

C:124

I:69.12 ± 10.54

C:71.48 ± 8.79

Chronic care model intervention, including health system, self-management support, decision support, etc., for a total of 9 months

Routine care

Community health service center team: multidisciplinary team collaboration, personalized management based on the CCM framework

①③④⑤⑥⑦⑧

Lynch⁴⁵

USA

I:97/

C:99

I:55.0 ± 10.3/

C:55.0 ± 10.3

LIFE intervention, 28 group sessions and peer supporter telephone follow-ups, for a total of 18 months

Standard care

Registered dietitian and peer supporter: culturally tailored diet and exercise education, group interaction, and self-monitoring guidance

①

Perez-Escamilla⁴⁶

USA

I:105/

C:106

I:55.46 ± 11.5

C:57.36 ± 12.1

Community health worker-led home intervention with 17 home visits over 12 months

Standard care

Community health workers collaborate with the medical team: providing culturally tailored family education and coordinating medical resources

①③④⑥⑦⑧

Presley⁴⁷

USA

I:62/

C:35

I:54.6 ± 8.2

C:55.8 ± 8.5

Self-management education and mobile health peer support for 6 months

Community self-management intervention alone

Community health workers communicate with the medical team through mobile applications to provide behavioral goal support and emotional support

①

Sherifali⁴⁸

Canada

I:233/

C:232

I:62 ± 11/

C:62 ± 10

Computer-generated customized feedback, regular feedback based on questionnaire results, for a total of 12 months

Standardized community services

Community project coordination: providing personalized advice via email and phone, linking with primary care physicians

①

Simmons⁴⁹

UK

I:781/

C:283

I:65 ± 9/

C:63 ± 10

Group/individual peer support, monthly nurse support meetings and structured education, for 12 months

Routine care

Peer support: Training PSF to provide non-directive support, focusing on life management and emotional support

①④

Spencer⁵⁰

USA

I:72/

C:92

I:50/

C:55

Community health worker intervention, group sessions + monthly home visits + clinic accompaniment, for 6 months

Routine care

Family health advocates: culturally tailored education, family support based on empowerment theory

①⑥⑧

Tang⁵¹

Canada

I:98/

C:98

I:60.5 ± 11.4

C:58.5 ± 10.9

Peer support intervention, weekly telephone contact for 3 months, bi-weekly telephone contact for 9 months, totaling 12 months

Routine care

Peer leaders: trained for 30 h, providing telephone support, assisting in setting self-management goals, problem-solving, and emotional support

①⑧

Zhang⁵²

China

I:1038/

C:1034

I:61.4 ± 7.1/

C:61.6 ± 6.9

Multidimensional digital health intervention, Patient/Family Health Promoter application and clinical decision support, for 24 months

Routine primary care

Digital platform and family support: FHP assists in self-management, physicians remotely monitor, government-led quality improvement

①③⑤⑥⑦⑧