Abstract :
Background: Type 2 Diabetes Mellitus (T2DM) continues to escalate globally, exerting not only metabolic but also profound psychosocial and economic burdens. Beyond pharmacological control, the lived experience of diabetes is shaped by patients’ beliefs, coping mechanisms, and sense of agency. Diabetes Self-Management Education and Support (DSMES) programs enhance self-care and glycaemic control; however, the evidence regarding their comprehensive impact on quality of life (QoL)—especially within culturally and spiritually adapted frameworks—remains fragmented.Objective: This review synthesises international evidence on DSMES and its influence on QoL in adults with T2DM, focusing on program features—duration, delivery mode, cultural adaptation, and spiritual integration—that predict superior outcomes.Materials and Methods: Following PRISMA 2020 guidelines, databases (PubMed, Scopus, Web of Science, Cochrane Library, AYUSH Research Portal) and grey literature were searched up to 15 August 2025. Randomised controlled trials (RCTs) and quasi-experimental studies using validated QoL tools (SF-36, WHOQOL-BREF, DQOL, EQ-5D) were included. Risk of bias was assessed using Cochrane RoB 2.0 and ROBINS-I. Descriptive pooled synthesis was conducted due to methodological heterogeneity.Results: Eleven studies (6 RCTs, 5 quasi-experimental) met inclusion criteria, spanning Asia, North America, Europe, and Africa. DSMES interventions improved physical, psychological, and social QoL domains (SMD ? 0.30–0.50). Programs integrating spiritual or cultural elements—such as Rajyoga, mindfulness, satwik diet, or faith-based counselling—achieved stronger and longer-lasting gains. Group-based and community-driven programs yielded higher adherence (70–95%) and lower attrition.Conclusions: DSMES programs significantly enhance QoL in T2DM by improving self-efficacy, psychological adaptation, and social participation. Integrating culturally relevant and spiritually grounded components amplifies these effects, creating sustainable, patient-centred care models.
Keyword :
DSMES, Type 2 diabetes, Quality of life, Rajyoga, Mindfulness, Self-efficacy, Spiritual adaptation, Holistic health