Background – The Chinese have the world’s highest population with diabetes, however, recommendations regarding the most appropriate education approaches are lacking.

Purpose – To systematically review evidence in both English and Chinese to indicate the size of the glycemic effect of different diabetes education approaches for Chinese patients.

Data sources - CINAHL Plus, Embase, Ovid Medline, Scopus and the China National Knowledge Infrastructure database were searched. 

Data selection – Studies were included if they were: randomised controlled trials with a detailed description of education approach, reporting on more than 50 Chinese-adult participants, providing glycemic outcome in absolute terms and with a follow-up period of over three months.

Data extraction – Data was systematically extracted and cross-checked by authors. Methodological quality was assessed.

Data synthesis – Fifty-three studies, including five English and 48 Chinese publications, were included. The overall weighted mean difference (WMD) in HbA_1c was -1.19% (-13mmol/mol). Ongoing regular education was most-commonly employed, with a reported WMD in HbA_1c, -2.02% (-22mmol/mol). Results were further enhanced in studies using information reinforcement strategies.

Limitations - Many included studies were deemed of neutral quality. The Chinese-language studies were short and provided limited information. The duration of study follow-up was less than 18 months.

Conclusions – Diabetes education in any format generates glycemic improvement for Chinese patients, but is particularly effective when an ongoing regular education strategy is employed. Innovative strategies aligned with cultural ways of learning may need to be considered for this ethnic group.