Researchers looked at studies from sub-Saharan Africa to understand how well nurses know about diabetes and what helps or hurts their learning. They found that many nurses don’t have enough knowledge about how diabetes works, how to use insulin, and how to help patients with diet and exercise. The biggest problems were lack of training programs, not enough staff at hospitals, and low pay. The good news is that nurses who work with diabetes patients regularly and take refresher courses learn better. This matters because more and more people in Africa have diabetes, and nurses are often the main healthcare workers helping these patients.

The Quick Take

  • What they studied: How much nurses in sub-Saharan Africa know about diabetes and what makes it easier or harder for them to learn about the disease
  • Who participated: This review looked at 20 different research studies that had already been done about nurses’ diabetes knowledge in sub-Saharan African countries
  • Key finding: Most nurses in sub-Saharan Africa have gaps in their diabetes knowledge, especially about how the disease works, blood tests, insulin use, diet, exercise, and complications
  • What it means for you: If you live in sub-Saharan Africa and have diabetes, knowing that your nurse may need more training suggests you should ask questions and seek additional education about managing your condition. This finding also shows that healthcare systems need to invest in better nurse training programs.

The Research Details

Researchers conducted a scoping review, which means they searched through many existing studies to get a complete picture of what’s known about a topic. They looked in major medical databases like PubMed and Scopus, as well as African-specific databases, searching for studies published up to November 2024. They started with nearly 3,000 research papers and carefully narrowed them down to 20 studies that specifically looked at nurses’ diabetes knowledge in sub-Saharan Africa.

A scoping review is like creating a map of what research exists on a topic rather than doing a brand new experiment. The researchers read through each study, checked if it met their requirements, and then summarized what all the studies together showed about the problem. This approach helps identify what we know, what we don’t know, and where more research is needed.

This type of review is important because it gives a complete overview of the problem across an entire region rather than looking at just one hospital or country. By combining information from multiple studies, researchers can see patterns and common issues that might not be obvious from a single study. This helps healthcare leaders understand the real scope of the problem and plan better solutions.

This review is reliable because it used a systematic approach, searching multiple databases and including studies from across sub-Saharan Africa. However, the strength of the findings depends on the quality of the 20 studies included. The review found that most studies were small or had other limitations, which means some findings may not apply equally to all nurses or all countries in the region. The fact that researchers updated their search through November 2024 makes the information current.

What the Results Show

The review found that nurses across sub-Saharan Africa commonly lack knowledge in several important areas of diabetes care. These gaps include not fully understanding how diabetes develops in the body, how to interpret blood test results, how to properly use and teach about insulin therapy, how to manage type 2 diabetes (the most common type), and how to advise patients about diet and exercise. Many nurses also didn’t have complete knowledge about diabetes complications like kidney disease, eye problems, and nerve damage.

The research identified major barriers preventing nurses from gaining better diabetes knowledge. The most common problems were lack of clear hospital guidelines for diabetes care, not enough staff to allow time for training, limited access to diabetes training programs, and low salaries that don’t encourage nurses to pursue additional education. Some nurses also worked in areas without access to modern diabetes treatment options.

On the positive side, the review found that certain things help nurses learn better. Nurses who regularly cared for diabetes patients and counseled them about their condition naturally learned more. Refresher courses focused on nutrition and diabetes management were also effective. This suggests that hands-on experience combined with structured training works well.

The studies showed that knowledge gaps varied depending on the specific topic. Insulin therapy and type 2 diabetes treatment were areas where many nurses struggled the most. Knowledge about exercise and diet recommendations was also frequently inadequate. The review noted that these gaps could directly affect patient care quality, since nurses often provide the main education and support for people managing diabetes.

This review builds on previous research showing that healthcare worker training is a challenge in many African countries. The findings align with other studies showing that lack of resources and training opportunities are common barriers to quality healthcare in sub-Saharan Africa. However, this is the first comprehensive review specifically mapping out diabetes knowledge gaps among nurses in this region, making it a valuable contribution to understanding the problem.

The review included only 20 studies, and some of these studies were small or had quality issues. The research was limited to studies published in certain databases, so some relevant studies may have been missed. The findings represent different countries and healthcare settings, so the problems may be worse in some areas than others. Additionally, the review couldn’t determine exactly how these knowledge gaps affect actual patient outcomes because most studies didn’t measure that directly.

The Bottom Line

Healthcare systems in sub-Saharan Africa should invest in structured diabetes training programs for nurses (high confidence). These programs should include hands-on experience with diabetes patients combined with classroom learning about disease management, insulin therapy, and patient education (moderate to high confidence). Hospitals should develop clear diabetes care guidelines and ensure nurses have time and resources to participate in refresher training courses (moderate confidence). Improving nurse salaries and working conditions may help retain trained nurses and encourage continued learning (moderate confidence based on indirect evidence).

Healthcare leaders and policymakers in sub-Saharan Africa should prioritize this issue because it directly affects the quality of care for the millions of people with diabetes in the region. Nurses themselves should care because better training improves their ability to help patients and may increase job satisfaction. People with diabetes in sub-Saharan Africa should be aware of this issue so they can seek additional education and ask informed questions about their care. International health organizations and donors should consider supporting diabetes training initiatives in the region.

Implementing training programs could improve nurse knowledge within 3-6 months for focused refresher courses. However, creating sustainable, system-wide improvements in diabetes care would likely take 1-2 years or longer, depending on how quickly healthcare systems can allocate resources and implement changes.

Want to Apply This Research?

  • If you have diabetes and live in sub-Saharan Africa, track your nurse interactions and the quality of diabetes education you receive. Note specific topics discussed (insulin use, diet, exercise, blood sugar monitoring) and rate how well you understood the information. This helps identify knowledge gaps and guides conversations with your healthcare team.
  • Use the app to create a personal diabetes education plan. Set reminders to ask your nurse specific questions about topics mentioned in this research (insulin therapy, diet, exercise, complications). Request referrals to diabetes education programs or nutritionists if available. Document what you learn and share it with family members.
  • Track your diabetes management outcomes (blood sugar levels, weight, exercise frequency, diet adherence) over time. Compare your progress before and after receiving better education from your healthcare team. Use the app to identify which topics need more learning and celebrate improvements in your knowledge and health metrics.

This review summarizes research about nurse training and diabetes knowledge in sub-Saharan Africa. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have diabetes or suspect you may have diabetes, please consult with a qualified healthcare provider for personalized medical advice. The findings in this review suggest areas where healthcare systems could improve, but individual experiences with nurses and healthcare quality may vary. Always communicate openly with your healthcare team about your concerns and educational needs.