Diabetes camps have supported children and adolescents with type 1 diabetes for nearly a century. These programmes combine clinical monitoring, diabetes education, physical activity, psychosocial support and peer interaction in an environment that conventional outpatient care cannot easily reproduce. Yet a crucial question remains: How strong, durable, equitable and economically defensible is the evidence supporting these camps?
A new scoping review published in Health Expectations examined 279 publications spanning 1931 to 2026 to answer this question. Rather than asking only whether diabetes camps work, the study evaluated the literature across five layers: what is known, how reliably it is known, how long the observed effects persist, who benefits and what remains unknown (Kurutkan & Arslanoğlu, 2026).
The apparent success of diabetes camps
The initial picture is encouraging. Among 104 studies reporting measurable outcomes, 90.4% documented improvement in at least one clinical, educational or psychosocial dimension. Diabetes camps appear capable of improving glycaemic control, self-management knowledge, treatment confidence, psychological well-being and peer support.
However, the overall success rate conceals substantial variation. Only 57.7% of outcome-reporting studies found entirely positive results. Another 32.7% reported mixed findings, meaning that improvement in one outcome was accompanied by non-significant or unfavourable findings in others. A camp may improve diabetes knowledge, for example, without producing a lasting improvement in glycated haemoglobin, anxiety or quality of life.
This distinction matters. Reporting that most studies found at least one benefit is not equivalent to demonstrating that diabetes camps produce consistent, comprehensive and durable effects.
The durability problem
The most important weakness concerns follow-up duration. Of the 199 publications included in the analytical dataset, only 12, or 6.0%, reported follow-up lasting six months or longer. Most studies measured outcomes during the camp or shortly after it ended.
The available longitudinal evidence also indicates that improvements in glycaemic control may deteriorate after participants return home. This suggests that the structured camp environment can produce short-term gains, but these gains may not survive the transition back to everyday routines.
Diabetes camps should therefore not be treated as isolated educational events. They may be more effective when integrated into a continuing care pathway that includes post-camp nursing follow-up, digital reinforcement, family engagement and periodic assessment. The end of a camp should not mark the end of support.
A literature dominated by weaker designs
The review also identified a methodological imbalance. Descriptive studies accounted for 51.8% of the evidence base, while only 6.5% employed controlled experimental designs. Just nine publications, representing 4.5% of the analytical dataset, combined an analytical or stronger research design, a follow-up period of at least six months and a measured outcome.
This does not mean that the reported benefits are invalid. It means that confidence in their magnitude, consistency and causal interpretation remains limited. Positive experiences, participant satisfaction and immediate improvements are valuable, but they cannot substitute for robust comparative designs and long-term outcome measurement.
Future research should use pragmatic controlled trials, prospective cohorts and standardised multidimensional outcome packages. Such packages should assess glycaemic control, severe hypoglycaemia, diabetes knowledge, self-management, quality of life, psychological well-being, family burden and healthcare utilisation.
The economic evidence gap
The most striking finding is the complete absence of economic evaluation. Across nearly a century of published research, the review found no direct cost-effectiveness analysis, no per-camp unit-cost calculation and no sufficiently detailed budget impact assessment.
This is not a minor reporting problem. Camps require specialised clinical staff, accommodation, equipment, food, transportation, emergency preparedness and continuous glucose management resources. Without cost data, decision-makers cannot compare diabetes camps with alternative education and support models.
A clinically beneficial intervention is not automatically affordable, scalable or sustainable. Conversely, an intervention that appears expensive may still represent good value if it prevents hospital admissions, acute complications or future healthcare use. These questions cannot be answered without economic evaluation.
The absence of cost-effectiveness evidence is particularly important for programmes operating through charities, donations or short-term grants. Without transparent cost and outcome data, successful camps may remain dependent on unstable funding rather than becoming integrated components of diabetes care.
Who is missing from diabetes camps?
The literature also raises concerns about equity. Only a small number of studies examined socioeconomic, geographical or ethnic disparities in camp participation. Available findings suggest that transportation difficulties, programme fees, limited information, rural residence and unequal referral opportunities may restrict access.
Consequently, the children who would benefit most from intensive education and peer support may be the least likely to attend. If participation depends on family income, geographical proximity or awareness of available programmes, diabetes camps may unintentionally reproduce existing inequalities in diabetes care.
Future evaluations should therefore report outcomes by socioeconomic status, ethnicity, rurality, disability, sex and baseline glycaemic control. Participation rates alone are insufficient. Programmes need to determine who is reached, who is excluded and why.
Physical or virtual camps?
The COVID-19 pandemic accelerated the development of virtual diabetes camps. These models may reduce travel requirements, extend geographical reach and lower some organisational costs. However, the review found no direct comparative evidence assessing physical and virtual camps in terms of clinical effectiveness, psychosocial outcomes, accessibility and cost.
Virtual delivery may improve access while weakening peer interaction, experiential learning or clinical observation. Physical camps may provide a stronger social environment but create financial and geographical barriers. Hybrid models may offer a practical compromise, but their effectiveness has not been adequately tested.
The appropriate question is not whether virtual camps should replace physical camps. The question is which delivery model works best for which participants, under what circumstances and at what cost.
Nursing is central to the solution
Nurses have historically coordinated insulin administration, glucose monitoring, hypoglycaemia surveillance, education and psychosocial support in diabetes camps. They are therefore central not only to programme delivery but also to closing the identified evidence gaps.
Nurse-led follow-up could transform camps from episodic experiences into longitudinal self-management interventions. Standardised data collection could enable comparison across programmes. Nursing professional organisations could also develop operational guidelines covering staffing, safety, education, equity, outcome measurement and post-camp continuity.
The evidence gap is therefore not merely an academic concern. It directly affects clinical accountability, workforce planning, resource allocation and the sustainability of nurse-led diabetes services.
From programme advocacy to programme accountability
The study introduces the “Diabetes Camp Paradox” to describe a field in which programmes appear broadly beneficial, while their durability, distribution and economic value remain insufficiently known. The evidence indicates that camps work, but their benefits are selective, temporally fragile, socially unequal and entirely uncosted (Kurutkan & Arslanoğlu, 2026).
The next generation of diabetes camp research requires three changes. Follow-up should extend to at least 6 to 12 months. Evaluation should move from single outcomes to multidimensional outcome packages. Research should also incorporate cost-effectiveness analysis, equity assessment and direct comparison of delivery models.
The future of diabetes camps will not be secured by repeating that they are beneficial. It will be secured by demonstrating how long their benefits last, who receives them, who is excluded and whether they represent a sustainable use of limited healthcare resources.
The article is available open access at: https://doi.org/10.1111/hex.70833
Reference
Kurutkan, M. N., & Arslanoğlu, I. (2026). The diabetes camp paradox: An evidence gap map of 279 publications and the anatomy of known unknowns. Health Expectations, 29, e70833. https://doi.org/10.1111/hex.70833