Background: Type 2 diabetes (T2D) is a chronic condition that requires engagement in daily self-management behaviors (SMBs) such as medication use, glucose monitoring, physical activity, and dietary modifications to achieve optimal health outcomes. These SMBs can be time-consuming, necessitating effective time-management strategies. This scoping review synthesized evidence on the role of time in diabetes SMBs and explored potential strategies to improve time management for individuals with T2D.
Methods: We conducted a comprehensive search of PubMed, PSYCHINFO, CINAHL, and Cochrane Library databases for peer-reviewed articles published from inception to March 2024. The review was guided by Arksey and O’Malley’s framework and PRISMA guideline for a scoping review.
Results: The search yielded 3138 articles, with 47 meeting the inclusion criteria. These studies, published between 2013 and 2024, were mostly concentrated in the last five years (72%), spanning 26 countries. The average sample size and participants’ age were 206 and 56, respectively. Most studies utilized a qualitative approach (55%), and 21% used a quantitative descriptive design. All 47 studies reported time constraints due to family, work, social, and caregiving responsibilities as significant barriers to diabetes SMBs. These constraints particularly impacted the general management of diabetes (reported in 36% of studies), physical activity (30%), diabetes education (15%), dietary modifications (6%), self-monitoring (4%), and complications prevention (2%). About half of the studies (49%) suggested strategies to address time-related barriers, including establishing dedicated routines for SMBs, leveraging family/social networks, flexible work schedules and accommodations, virtual/SMS-based education, and automation of SMB tasks and data capturing. However, the five studies that adopted quasi-experimental and true experimental designs only tested telehealth-based strategies, and they demonstrated positive outcomes.
Conclusions: Our review highlights that time constraints from work, social, and family obligations are a prevalent global barrier to diabetes SMBs, with limited evidence on effective interventions to overcome this barrier. Addressing time-related barriers will likely require multilevel approaches, encompassing individual planning and role adjustments, interpersonal support from family and social networks, and broader structural changes in healthcare systems and workplace policies.