Facilitators and Barriers of Self-management in Pediatric Type 1 Diabetes: A Systematic Review
| Author | Afsaneh Ranaei | en |
| Author | Elaheh Lael-Monfared | en |
| Author | Hossein Amani | en |
| Author | Azam Sabahi | en |
| Author | Nooshin Peyman | en |
| Orcid | Azam Sabahi [0000-0003-1507-5120] | en |
| Orcid | Nooshin Peyman [0000-0002-6218-4787] | en |
| Issued Date | 2026-01-31 | en |
| Abstract | Context: Self-management of type 1 diabetes in children and adolescents is critical for achieving optimal health outcomes. Identifying facilitators and barriers can guide the development of effective interventions. Objectives: This systematic review synthesizes interventional studies to examine key factors influencing self-management and their impact on outcomes. Methods: Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines, PubMed, Scopus, and Web of Science were searched up to August 10, 2025. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental designs. Study quality was assessed using the risk of bias 2 (RoB 2) tool for randomized trials and risk of bias in non-randomized studies (non-RCTs) of interventions (ROBINS-I) for non-randomized studies. Results: Thirty-four studies comprising 4,584 participants aged 3 - 19 years were included. Of these, 65% were rated as low risk of bias and 35% as moderate risk. Interventions mainly involved self-management education (55%), family-centered programs (41%), digital technologies (35%), motivational strategies (32%), and psychological support (29%). Key facilitators included family involvement (47%), structured and repeated education (41%), healthcare team engagement (35%), motivational strategies (32%), and technological tools (30%). Barriers included fear of hypoglycemia (FOH, 29%), emotional stress (25%), lack of peer support (21%), limited access to educational resources (18%), cultural or language challenges (15%), and insufficient school-based education (12%). Interventions generally improved hemoglobin A1c (HbA1c), self-care behaviors, knowledge, self-efficacy, and quality of life. Conclusions: This review underscores the multidimensional nature of self-management in pediatric type 1 diabetes. Effective programs should address both individual and contextual barriers while leveraging facilitators such as family support and technology. Given the generally low-to-moderate risk of bias, findings are robust but highlight the need for culturally tailored and longitudinal research. | en |
| DOI | https://doi.org/10.5812/jjcdc-164179 | en |
| URI | https://brieflands.com/journals/jjcdc/articles/164179 | en |
| Keyword | Type 1 Diabetes | en |
| Keyword | Children and Adolescents | en |
| Keyword | Self-management | en |
| Keyword | Barriers | en |
| Keyword | Facilitators | en |
| Keyword | Health Outcomes | en |
| Publisher | Brieflands | en |
| Title | Facilitators and Barriers of Self-management in Pediatric Type 1 Diabetes: A Systematic Review | en |
| Type | Systematic Review | en |
Files
Original bundle
1 - 1 of 1
Loading...
- Name:
- jjcdc-15-1-164179-publish-pdf.pdf
- Size:
- 875.58 KB
- Format:
- Adobe Portable Document Format
- Description:
- Article/s PDF