Abstract
Background Appropriate diabetic self-care is indispensable to prevent and limit diabetic associated short and long term complications including death. Despite the well-recorded devastating complications of diabetes mellitus, a pooled percentage of diabetic patients applying self-care and its determinants at the national level have remained unknown. Therefore, this comprehensive systematic review and meta-analysis is aimed at determining the pooled national percentage of diabetic self-care practice and its determinants among adult diabetic patients in Ethiopian. Methods: Different electronic databases including PubMed/Medline and search engines such as Google scholar were used to retrieve published studies. The Joanna Briggs Institute quality appraisal checklists were used to appraise the quality of studies. Data were extracted using excel spreadsheets and analyses were done by STATA 14. Heterogeneity among studies was diagnosed using the I2 test. The DerSimonian and Laird random-effects model was employed for substantial heterogeneity (I2>50%). The pooled estimate of diabetic self-care and odds ratio was reported based on the 95% CI. Results: A total of 3861 studies were identified, of which only 19 studies have reached the final qualitative synthesis and quantitative analysis. Well over half of the Ethiopian diabetic patients have good self-care 54.04% (47.07-61.01, I2 =97.3, P<0.001). Subgroup analysis showed that the highest pooled estimate was in Southern Nations Nationalities and Peoples 81.96(71.85-92.04), I2=89.1, P<0.002) while the lowest was from the Hareri region 44.53(32.16-56.89) I2=94%%, P<0.001). Being knowledgeable about diabetes mellitus 2.69 (1.62, 4.46; I2 =99%, P<0.001), having good social support 2.25(1.49-3.39; I2=99%, P=0.00), owning private glucometer 3.04(1.64, 5.65; I2=97.4, P<0.001), and being urban residents 3.26(2.24, 4.74; I2=96.3%, P<0.001) have promoted diabetic victims to apply self-care practice. Conclusions: Despite the life-threatening complications of diabetes mellitus, the percentage of patients applying self-care has remained low in Ethiopia, depicting the high proportion of diabetic patients are prone to develop long and short term complications of diabetes mellitus. Therefore, improving the client’s awareness about the disease and counseling clients about the significance of social support are believed to be possible strategies to improve self-care practice and policymakers are strongly recommended to combat complications to attain sustainable development goal 3.4 aims to reduce premature death.