Desvelando nuevas perspectivas en el manejo de la Diabetes Mellitus Tipo 2: un meta-análisis y síntesis estadística de la literatura sobre intervenciones de enfermería y fisioterapia

Autores/as

  • Eman shokr Department of Community Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Airport Street, Amman, Jordan. https://orcid.org/0000-0002-3035-7073
  • Rasha El-Marakby Department of Physical Therapy, Faculty of Applied Medical Sciences, Irbid National University, Irbid, Jordan. https://orcid.org/0009-0007-4132-0093
  • Kamlah AL-Olimat Department of Maternal and Child Health, School of Nursing, Zarqa University, Zarqa, Jordan. https://orcid.org/0009-0007-9635-846X
  • Rasha Alqadi Department of Medical-Surgical Nursing, North Private College of Nursing, Arar, Saudi Arabia. https://orcid.org/0000-0002-1831-0029
  • Hadeel Alsirhani Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia. https://orcid.org/0009-0000-8405-1582
  • Soher Abdelaziz Department of Gerontological Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt. https://orcid.org/0000-0003-2505-063X
  • Asmaa Hassan Department of Community Health Nursing, Faculty of Nursing, Zarqa University, Zarqa, Jordan
  • Amira Afify Department of Physical Therapy for Internal, Cardio Pulmonary and Geriatric Medicine, Faculty of Physical Therapy, Al-Ryada University for Science and Technology, Egypt.

DOI:

https://doi.org/10.47197/retos.v68.116122

Palabras clave:

Diabetes Mellitus tipo 2, intervención de enfermería, fisioterapia, terapia de ejercicio, educación del paciente, metaanálisis, control glucémico

Resumen

Introducción: La gestión efectiva de la diabetes mellitus tipo 2 (DM2) requiere un enfoque multidisciplinario. Este estudio tiene como objetivo cuantificar el efecto combinado de las intervenciones de enfermería y fisioterapia sobre los resultados en adultos con DM2.

Objetivo: Evaluar el impacto de las intervenciones de enfermería y fisioterapia en los resultados clave en pacientes con DM2.

Metodología: Se realizó una revisión sistemática y un metaanálisis siguiendo las directrices PRISMA (búsqueda realizada hasta julio de 2024) en PubMed, Scopus, Web of Science, Cochrane y Google Scholar. Se incluyeron ensayos controlados aleatorios y ensayos clínicos controlados que involucraron adultos con DM2, centrados en intervenciones de enfermería (educación del paciente y/o apoyo al autocuidado) y/o fisioterapia (entrenamiento físico y/o terapia física). Se analizaron 18 estudios (N=1,243) utilizando modelos de efectos aleatorios para el agrupamiento de las diferencias medias.

Resultados: Los resultados clave incluyeron HbA1c, IMC, función física y calidad de vida (QoL). La intervención combinada de enfermería y fisioterapia mejoró significativamente el control glucémico (HbA1c 7.0% frente a 7.5%, diferencia media ponderada –0.52%, IC 95% –0.68 a –0.36, p<0.001), redujo el IMC (DM –1.2 kg/m², IC 95% –1.7 a –0.7, p<0.001), mejoró la capacidad de ejercicio (+45m en la caminata de 6 minutos, IC 95% 30–60) y la QoL (+5.1 puntos SF36 físicos, IC 95% 3.0–7.2).

Conclusión: Las intervenciones combinadas de enfermería y fisioterapia mejoraron significativamente los comportamientos de autocuidado, el control metabólico y los resultados funcionales en pacientes con DM2. Estos hallazgos apoyan la recomendación de programas colaborativos de enfermería y fisioterapia en el cuidado de la diabetes.

Citas

Bani Salameh, A., Al-Sheyab, N., El-Hneiti, M., Shaheen, A., Williams, L. M., & Gallagher, R. (2017). Effectiveness of a 12-week school-based educational preventive programme on weight and fasting blood glucose in "at-risk" adolescents of type 2 diabetes mellitus: Randomized controlled trial. International journal of nursing practice, 23(3), 10.1111/ijn.12528. https://doi.org/10.1111/ijn.12528

Beaudin, J., Chouinard, M., Girard, A., Houle, J., Ellefsen, É., & Hudon, C. (2022). Integrated self management support provided by primary care nurses to persons with chronic diseases and common mental disorders: A scoping review. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-01000-2

Castaneda, C., Layne, J. E., Munoz Orians, L., Gordon, P. L., Walsmith, J., Foldvari, M., Roubenoff, R., Tucker, K. L., & Nelson, M. E. (2002). A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care, 25(12), 2335–2341. https://doi.org/10.2337/diacare.25.12.2335

Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B., Rubin, R. R., Chasan Taber, L., Albright, A., & Braun, B. (2010). Exercise and type 2 diabetes. Diabetes Care, 33(12). https://doi.org/10.2337/dc10-9990

Crossman, E. (2023). Physical activity in patients with type 2 diabetes mellitus: Updated consensus statement from the ACSM. PubMed, 107(1), 103. https://pubmed.ncbi.nlm.nih.gov/36689953

Dailah, H. G. (2024). The influence of nurse led interventions on disease management in patients with diabetes mellitus: A narrative review. Healthcare, 12(3), 352. https://doi.org/10.3390/healthcare12030352

Doupis, J., Karras, K., & Avramidis, K. (2021). The role of individualized exercise prescription in type 2 diabetes mellitus management. touchREVIEWS in Endocrinology, 17(1), 2. https://doi.org/10.17925/ee.2021.17.1.2

Fontaine, G., Vinette, B., Weight, C., Maheu Cadotte, M., Lavallée, A., Deschênes, M., Lapierre, A., Castiglione, S. A., Chicoine, G., Rouleau, G., Argiropoulos, N., Konnyu, K. J., Mooney, M., Cassidy, C., Mailhot, T., Lavoie, P., Pépin, C., Cossette, S., Gagnon, M., … Middleton, S. (2024). Effects of implementation strategies on nursing practice and patient outcomes: A comprehensive systematic review and meta analysis. Implementation Science, 19(1). https://doi.org/10.1186/s13012-024-01398-0

Grey, M., Schreiner, B., & Pyle, L. (2009). Development of a diabetes education program for youth with type 2 diabetes. The Diabetes Educator, 35(1), 108. https://doi.org/10.1177/0145721708325156

Haas, T. L., Lloyd, P. G., Yang, H., & Terjung, R. L. (2012). Exercise training and peripheral arterial disease. Comprehensive Physiology, 2933. https://doi.org/10.1002/cphy.c110065

Harbi, S. S. A., Alajmi, M. M., Algabbas, S. M., & Alharbi, M. S. (2022). The comparison of self management group education and the standard care for patients with type 2 diabetes mellitus: An updated systematic review and meta analysis. Journal of Family Medicine and Primary Care, 11(8), 4299. https://doi.org/10.4103/jfmpc.jfmpc_2087_21

Hassan, K., Alghamdi, M. A., Althagafi, W. E., Alqarni, S. M., Ramadhan, A. K. A., Darwish, R. M. A., Alanazi, R. R., Alshehri, B. H., Albalawi, A. A., Alqaisoom, M. A., Hussain, A. M., Almezher, S. U., Rajab, H. A., Ghazi, R. H., Asiri, H. A. A., & Aljallal, A. A. (2020). Application of new modifying models and lifestyle changes and its role in providing better treatment for diabetes mellitus. International Journal of Community Medicine and Public Health, 7(10), 4146. https://doi.org/10.18203/2394-6040.ijcmph20204015

Kim, J., & Hur, M. (2021). The effects of dietary education interventions on individuals with type 2 diabetes: A systematic review and meta analysis. International Journal of Environmental Research and Public Health, 18(16), 8439. https://doi.org/10.3390/ijerph18168439

Lee, A., Yanagihara, R. T., Lee, C. S., Blazes, M., Jung, H., Chee, Y. E., Gencarella, M. D., Gee, H., Maa, A. Y., Cockerham, G. C., Lynch, M. G., & Boyko, E. J. (2021). Multicenter, head to head, real world validation study of seven automated artificial intelligence diabetic retinopathy screening systems. Diabetes Care, 44(5), 1168. https://doi.org/10.2337/dc20-1877

Lorito, C. D., Long, A., Byrne, A., Harwood, R., Gladman, J., Schneider, S., Logan, P., Bosco, A., & van der Wardt, V. (2020). Exercise interventions for older adults: A systematic review of meta analyses. Journal of Sport and Health Science, 10(1), 29. https://doi.org/10.1016/j.jshs.2020.06.003

Martos Cabrera, M. B., Gómez Urquiza, J. L., Cañadas González, G., Romero Bejar, J. L., Suleiman Martos, N., Cañadas De la Fuente, G. A., & Albendín García, L. (2021). Nursing intense health education intervention for persons with type 2 diabetes: A quasi experimental study. Healthcare, 9(7), 832. https://doi.org/10.3390/healthcare9070832

Mohammad Rahimi, G. R., Aminzadeh, R., Azimkhani, A., & Saatchian, V. (2022). The effect of exercise interventions to improve psychosocial aspects and glycemic control in type 2 diabetic patients: A systematic review and meta analysis of randomized controlled trials. Biological Research for Nursing, 24(1), 10–23. https://doi.org/10.1177/10998004211022849

Ofori, S., & Unachukwu, C. (2014). Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 7, 159. https://doi.org/10.2147/dmso.s62320

Parchwani, D., Sanghani, N. S., Palandurkar, K., Shah, A., & Dhanani, J. (2013). Impact of lifestyle modification on glycemic control in patients with type 2 diabetes mellitus. Indian Journal of Endocrinology and Metabolism, 17(6), 1030. https://doi.org/10.4103/2230-8210.122618

Pfeifer, L. O., De Nardi, A. T., da Silva, L. X. N., Botton, C. E., do Nascimento, D. M., Teodoro, J. L., Schaan, B. D., & Umpierre, D. (2022). Association between physical exercise interventions participation and functional capacity in individuals with type 2 diabetes: A systematic review and meta analysis of controlled trials. Sports Medicine – Open, 8, 34. https://doi.org/10.1186/s40798-022-00422-1

Shafiee, F., Khoshvishkaie, E., Davoodi, A., Kalantar, A. D., Jouybari, H. B., & Ataee, R. (2018). The determination of blood glucose lowering and metabolic effects of Mespilus germanica L. hydroacetonic extract on streptozocin induced diabetic Balb/c mice. Medicines, 5(1), 1. https://doi.org/10.3390/medicines5010001

Siaw, M. Y. L., & Lee, J. V. (2018). Multidisciplinary collaborative care in the management of patients with uncontrolled diabetes: A systematic review and meta analysis. International Journal of Clinical Practice, 73(2). https://doi.org/10.1111/ijcp.13288

Sigal, R. J., Kenny, G. P., Boulé, N. G., Wells, G. A., Prud’homme, D., Fortier, M., Reid, R. D., Tulloch, H., Coyle, D., Phillips, P., Jennings, A., & Jaffey, J. (2007). Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: A randomized trial. Annals of Internal Medicine, 147(6), 357–369. https://doi.org/10.7326/0003-4819-147-6-200709180-00005

Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda Sceppa, C., & White, R. D. (2006). Physical activity/exercise and type 2 diabetes. Diabetes Care, 29(6), 1433. https://doi.org/10.2337/dc06-9910

Stewart, K. J. (2004). Role of exercise training on cardiovascular disease in persons who have type 2 diabetes and hypertension. Cardiology Clinics, 22(4), 569. https://doi.org/10.1016/j.ccl.2004.06.007

Subramanian, S. C., Arjunan, P., & Akila, P. (2020). Effectiveness of nurse led intervention on self management, self efficacy and blood glucose level among patients with type 2 diabetes mellitus. Journal of Complementary and Integrative Medicine, 17(3). https://doi.org/10.1515/jcim-2019-0064

Al-Ghabeesh, S., Khalifeh, A. H., & Rayan, A. (2024). Evidence-based practice knowledge, attitude, practice and barriers as predictors of stay intent among Jordanian registered nurses: a cross-sectional study. BMJ open, 14(7), e082173. https://doi.org/10.1136/bmjopen-2023-082173

Thakur, K., Sharma, S. K., Kant, R., & Kalyani, V. (2025). Glycemic control in adult patients with type 2 diabetes mellitus receiving care through a nurse led diabetic follow up clinic versus conventional care: A randomized controlled trial. Cureus, 17(2), e79659. https://doi.org/10.7759/cureus.79659

Usman, F., Shah, H. S., Zaib, S., Manee, S., Mudassir, J., Khan, A., Batiha, G. E., Abualnaja, K. M., Alhashmialameer, D., & Khan, I. (2021). Fabrication and biological assessment of antidiabetic α Mangostin loaded nanosponges: In vitro, in vivo, and in silico studies. Molecules, 26(21), 6633. https://doi.org/10.3390/molecules26216633

Wadden, T. A., Tronieri, J. S., & Butryn, M. L. (2020). Lifestyle modification approaches for the treatment of obesity in adults. American Psychologist, 75(2), 235. https://doi.org/10.1037/amp0000517

Wang, Z., Wang, J., & Chan, P. (2013). Treating type 2 diabetes mellitus with traditional Chinese and Indian medicinal herbs. Evidence Based Complementary and Alternative Medicine, 2013, Article ID 343594. https://doi.org/10.1155/2013/343594

Williams, D. M., Jones, H., & Stephens, J. W. (2022). Personalized type 2 diabetes management: An update on recent advances and recommendations. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 15, 281. https://doi.org/10.2147/dmso.s331654

Wilmot, E. G., & Idris, I. (2014). Early onset type 2 diabetes: Risk factors, clinical impact and management. Therapeutic Advances in Chronic Disease, 5(6), 234. https://doi.org/10.1177/2040622314548679

Wu, S., & Armstrong, D. G. (2008). Clinical outcome of diabetic foot ulcers treated with negative pressure wound therapy and the transition from acute care to home care. International Wound Journal, 5, 10. https://doi.org/10.1111/j.1742-481x.2008.00466.x

Descargas

Publicado

2025-05-20

Cómo citar

shokr, E., El-Marakby, R., AL-Olimat, K., Alqadi, R., Alsirhani, H., Abdelaziz, S., … Afify, A. (2025). Desvelando nuevas perspectivas en el manejo de la Diabetes Mellitus Tipo 2: un meta-análisis y síntesis estadística de la literatura sobre intervenciones de enfermería y fisioterapia. Retos, 68, 585–595. https://doi.org/10.47197/retos.v68.116122

Número

Sección

Artículos de carácter científico: investigaciones básicas y/o aplicadas

Artículos más leídos del mismo autor/a