diabetestalk.net

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis

Effect Of Lifestyle Interventions On Cardiovascular Risk Factors Among Adults Without Impaired Glucose Tolerance Or Diabetes: A Systematic Review And Meta-analysis

Effect Of Lifestyle Interventions On Cardiovascular Risk Factors Among Adults Without Impaired Glucose Tolerance Or Diabetes: A Systematic Review And Meta-analysis

Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click here . Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis Affiliation Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America Contributed equally to this work with: Heather M. Devlin, Bryce Smith, Giuseppina Imperatore, William Thomas, Felipe Lobelo, Mohammed K. Ali, Keri Norris, Stephanie Gruss, Barbara Bardenheier, Pyone Cho, Isabel Garcia de Quevedo, Uma Mudaliar, Christopher D. Jones, Jeffrey M. Durthaler, Jinan Saaddine, Linda S. Geiss, Edward W. Gregg Affiliation Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America Contributed equally to this work with: Heather M. Devlin, Bryce Smith, Giuseppina Imperatore, William Thomas, Felipe Lobelo, Mohammed K. Ali, Keri Norris, Stephanie Gruss, Barbara Bardenheier, Pyone Cho, Isabel Garcia de Quevedo, Uma Mudaliar, Christopher D. Jones, Jeffrey M. Durthaler, Jinan Saaddine, Linda S. Geiss, Edward W. Gregg Affiliation Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America Contributed equally to this work with: Heather M. Devlin, Bryce Smith, Giuseppina Imperatore, William Thomas, Felipe Lobelo, Mohammed K. Ali, Keri Norris, Stephanie Gruss, Barbara Bardenheier, Pyone Cho, Isabel Garcia de Quevedo, Continue reading >>

Diabetes Remission After Nonsurgical Intensive Lifestyle Intervention In Obese Patients With Type 2 Diabetes

Diabetes Remission After Nonsurgical Intensive Lifestyle Intervention In Obese Patients With Type 2 Diabetes

Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA Received 17 March 2015; Revised 6 May 2015; Accepted 6 May 2015 Copyright 2015 Adham Mottalib et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Partial or complete remission from type 2 diabetes was recently observed after bariatric surgeries. Limited data is available about the possibility of inducing diabetes remission through intensive weight reduction. We retrospectively evaluated diabetes remissions after one year of the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week intensive program for diabetes weight management in real-world clinical practice. Among 120 obese patients with type 2 diabetes who completed the program, 88 patients returned for follow-up at one year. Nineteen patients (21.6%) had major improvement in their glycemic control, defined as achieving an A1C <6.5% after one year. Four patients (4.5%) achieved either partial or complete diabetes remission defined as A1C <6.5% and <5.7%, respectively, on no antihyperglycemic medications for one year; 2 achieved partial remission (2.3%) and 2 achieved complete remission (2.3%). At the time of intervention, patients who achieved diabetes remission had shorter diabetes duration (<5 years) and lower A1C (<8%) and were treated with fewer than 2 oral medications. They achieved a weight reduction of >7% after 12 weeks. These results indicate that a subset of obese patients with type 2 diabetes is appropriate for intensive lifestyle intervention with Continue reading >>

Diabetes Management: Intensive Lifestyle Interventions For Patients With Type 2 Diabetes

Diabetes Management: Intensive Lifestyle Interventions For Patients With Type 2 Diabetes

The Community Preventive Services Task Force (CPSTF) recommends intensive lifestyle interventions for patients with type 2 diabetes to improve glycemic control and reduce risk factors for cardiovascular disease. Intervention Intensive lifestyle interventions provide ongoing counseling, coaching, or individualized guidance to patients with type 2 diabetes to help them change their diet, level of physical activity, or both. Patients must interact with program staff multiple times for a period of six months or longer. Dietary components may include tailored advice, and physical activity components may include structured and personalized guidance or supervised exercise training. Programs may have weight loss goals or include additional components related to weight loss or maintenance. The largest and longest trial to date provided intensive individual and group counseling and extended interpersonal support for dietary changes, regular physical activity, and weight management. Read the full CPSTF Finding and Rationale Statement [PDF - 603 kB] for details including implementation issues, possible added benefits, potential harms, and evidence gaps. This expedited finding was based on the following published systematic review: Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2 diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37-47. Promotional Materials Continue reading >>

Lifestyle Interventions For Adults With Impaired Glucose Tolerance: A Systematic Review And Meta-analysis Of The Effects On Glycemic Control

Lifestyle Interventions For Adults With Impaired Glucose Tolerance: A Systematic Review And Meta-analysis Of The Effects On Glycemic Control

Lifestyle Interventions for Adults with Impaired Glucose Tolerance: A Systematic Review and Meta-Analysis of the Effects on Glycemic Control Ningbo Municipal Center for Disease Control and Prevention, China Furong Administration of Work Safety, China Ningbo Municipal Center for Disease Control and Prevention, China Ningbo Municipal Center for Disease Control and Prevention, China Medicine School of Ningbo University, China Yinzhou Hospital Affiliated to Medicine School of Ningbo University, China Released on J-STAGE: February 01, 2015 [Advance Publication] Released: - Received: February 24, 2014 Revised: - Accepted: May 21, 2014 Objective Previous meta-analyses have demonstrated that lifestyle modification can reduce the blood glucose levels in patients with type 2 diabetes, although the effects of changes in the blood glucose level on impaired glucose tolerance (IGT) remain controversial. This review therefore aimed to determine the efficacy of lifestyle interventions in adults with IGT. Methods We searched the Medline, Cochrane Library, EMBASE and Science Citation Index databases and reference lists of the included articles. Two independent reviewers extracted the data and assessed the quality of the included studies; a total of nine randomized controlled trials met the inclusion criteria. In addition, we tested for trial heterogeneity and calculated the pooled effects size using the random effects model. Results The overall interventions were associated with a decline in the 2-hour plasma glucose levels [standardized mean differences (SMD) -0.56; 95% confidence interval (CI), -1.01 to -0.10; I2, 96.6%]. Moreover, dietary intervention (SMD -0.53; 95% CI -0.77 to -0.28) and physical intervention (SMD -0.42; 95% CI -0.63 to -0.20) were each associated with a decline in Continue reading >>

Jmir-the Impact Of Automated Brief Messages Promoting Lifestyle Changes Delivered Via Mobile Devices To People With Type 2 Diabetes: A Systematic Literature Review And Meta-analysis Of Controlled Trials | Arambepola | Journal Of Medical Internet Research

Jmir-the Impact Of Automated Brief Messages Promoting Lifestyle Changes Delivered Via Mobile Devices To People With Type 2 Diabetes: A Systematic Literature Review And Meta-analysis Of Controlled Trials | Arambepola | Journal Of Medical Internet Research

The Karma system is currently undergoing maintenance (Monday, January 29, 2018). The maintenance period has been extended to 8PM EST. Karma Credits will not be available for redeeming during maintenance. Preprints (earlier versions) of this paper are available at , first published Dec 09, 2015. This paper is in the following e-collection/theme issue: The Impact of Automated Brief Messages Promoting Lifestyle Changes Delivered Via Mobile Devices to People with Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Controlled Trials 1University of Colombo, Faculty of Medicine, Colombo, Sri Lanka 2University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, United Kingdom 3University of Oxford, Bodleian Libraries, Oxford, United Kingdom 4University of Manchester, School of Psychological Sciences, Manchester, United Kingdom Nuffield Department of Primary Care Health Sciences Background: Brief automated messages have the potential to support self-management in people with type 2 diabetes, but their effect compared with usual care is unclear. Objective: To examine the effectiveness of interventions to change lifestyle behavior delivered via automated brief messaging in patients with type 2 diabetes. Methods: A systematic literature review of controlled trials examined the impact of interventions, delivered by brief messaging, and intended to promote lifestyle change in people with type 2 diabetes, on behavioral and clinical outcomes. Bibliographic databases searched included Medline, Embase, CINAHL, PsycINFO, and ISI WoK. Two reviewers independently screened citations. We extracted information on study risk of bias, setting (high versus low- and middle-income countries) and intervention characteristics (including use of theory and behavior Continue reading >>

[full Text] Type 2 Diabetes: Cost-effectiveness Of Medication Adherence And Lifest | Ppa

[full Text] Type 2 Diabetes: Cost-effectiveness Of Medication Adherence And Lifest | Ppa

Editor who approved publication: Dr Johnny Chen Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia Introduction: Type 2 diabetes is a major burden for the payer, however, with proper medication adherence, diet and exercise regime, complication occurrence rates, and consequently costs can be altered. Aims: The aim of this study was to conduct a cost-effectiveness analysis on real patient data and evaluate which medication adherence or lifestyle intervention is less cost demanding for the payer. Methods: Medline was searched systematically for published type 2 diabetes interventions regarding medication adherence and lifestyle in order to determine their efficacies, that were then used in the cost-effectiveness analysis. For cost-effectiveness analysis-required disease progression simulation, United Kingdom Prospective Diabetes Study Outcomes model 2.0 and Slovenian type 2 diabetes patient cohort were used. The intervention duration was set to 1, 2, 5, and 10 years. Complications and drug costs in euro (EUR) were based on previously published type 2 diabetes costs from the Health Care payer perspective in Slovenia. Results: Literature search proved the following interventions to be effective in type 2 diabetes patients: medication adherence, the Mediterranean diet, aerobic, resistance, and combined exercise. The long-term simulation resulted in no payer net savings. The model predicted following quality-adjusted life-years (QALY) gained and incremental costs for QALY gained (EUR/QALYg) after 10 years of intervention: high-efficacy medication adherence (0.245 QALY; 9,984 EUR/QALYg), combined exercise (0.119 QALY; 46,411 EUR/QALYg), low-efficacy medication adherence (0.075 QALY; 30,967 EUR/QALYg), aerobic exercise (0.069 QALY; 80,798 EUR/QALYg), the Mediterr Continue reading >>

Physical Exercise For The Prevention And Treatment Of Type 2 Diabetes - Em|consulte

Physical Exercise For The Prevention And Treatment Of Type 2 Diabetes - Em|consulte

Received:9June2010; accepted:14June2010 Physical exercise for the prevention and treatment of type 2 diabetes Exercice physique, prvention et traitement du diabte de type 2 , J.-F.Gautier d , e , f , H.Hanaire a , b aDepartment of Diabetology, Metabolic Diseases and Nutrition, CHU de Toulouse, 31073 Toulouse, France bUniversity Toulouse III, 31073 Toulouse, France cInserm unit U558, 37, alles Jules-Guesdes, 31073 Toulouse, France dDepartment of Diabetes and Endocrinology, hpital Saint-Louis, Assistance PubliqueHpitaux de Paris, Paris, France eUniversity Paris-Diderot Paris 7, Paris, France fUMR-S Inserm 872, centre de recherche des Cordeliers, University Pierre-et-Marie-Curie, Paris 6, Paris, France Corresponding author. Tel.: +33 5 61 32 26 85; fax: +33 5 61 32 31 23. The prevalence of type 2 diabetes is rapidly increasing worldwide, yet its primary prevention and treatment are still a challenge. The objectives of this review are to assess the effects of exercise on the prevention of type 2 diabetes in high-risk individuals and on glycaemic control in type 2 diabetic patients. Considering the available reports, there is unequivocal and strong evidence that physical exercise can prevent or delay progression to type 2 diabetes in subjects with impaired glucose tolerance. Also, lifestyle interventions, including diet and physical exercise, can result in a reduction of around 50% in diabetes incidence that persists even after the individual lifestyle counselling has stopped. In addition, short-term randomized studies have confirmed that physical training based on endurance and/or resistance exercises can also improve blood glucose control in type 2 diabetics with a mean glycated haemoglobin decrease of 0.6%. Thus, physical exercise should be part of any therapeutic strate Continue reading >>

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis

Abstract The effect of lifestyle intervention on clinical risk factors in patients with type 2 diabetes is unclear. The aim of this meta-analysis was to evaluate the effects of comprehensive lifestyle change, such as diet, exercise, and education, on clinical markers that are risk-factors for cardiovascular disease in patients with type 2 diabetes. We searched Medline, Cochrane, EMBASE, and Google Scholar (up to August 31, 2013) for randomized controlled trials that compared standard of care (control group) with treatment regimens that included changes in lifestyle (intervention group). The primary outcome was reduction in risk factors of cardiovascular disease including body mass index (BMI), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). A total of 16 studies were included in the meta-analysis. The standardized difference in means of change from baseline significantly favored the intervention compared with the control group in BMI (− 0.29; 95% CI, − 0.52 to − 0.06, P = 0.014), HbA1c (− 0.37; 95% CI, − 0.59 to − 0.14, P = 0.001), SBP (− 0.16: 95% CI, − 0.29 to − 0.03, P = 0.016), DBP (− 0.27, 95% CI = − 0.41 to − 0.12, P < 0.001). There was no difference between the intervention and control groups in HDL-c (0.05; 95% CI, − 0.10 to 0.21; P = 0.503) and LDL-c (− 0.14; 95% CI, − 0.29 to 0.02; P = 0.092). The meta-analysis found that lifestyle intervention showed significant benefit in risk factors that are known to be associated with development of cardiovascular disease in patients with type 2 diabetes. Fig. 1. Flow chart for study selection. Fig. 2. The quality assessment for each included study was sum Continue reading >>

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis

Objective. The effect of lifestyle intervention on clinical risk factors in patients with type 2 diabetes is unclear. The aim of this meta-analysis was to evaluate the effects of comprehensive lifestyle change, such as diet, exercise, and education, on clinical markers that are risk-factors for cardiovascular disease in patients with type 2 diabetes. Methods. We searched Medline, Cochrane, EMBASE, and Google Scholar (up to August 31, 2013) for randomized controlled trials that compared standard of care (control group) with treatment regimens that included changes in lifestyle (intervention group). The primary outcome was reduction in risk factors of cardiovascular disease including body mass index (BMI), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). Results. A total of 16 studies were included in the meta-analysis. The standardized difference in means of change from baseline significantly favored the intervention compared with the control group in BMI ( 0.29; 95% CI, 0.52 to 0.06, P = 0.014), HbA1c (0.37; 95% CI, 0.59 to 0.14, P = 0.001), SBP ( 0.16: 95% CI, 0.29 to 0.03, P = 0.016), DBP ( 0.27, 95% CI = 0.41 to 0.12, P < 0.001). There was no difference between the intervention and control groups in HDL-c (0.05; 95% CI, 0.10 to 0.21; P = 0.503) and LDL-c ( 0.14; 95% CI, 0.29 to 0.02; P = 0.092). Conclusions. The meta-analysis found that lifestyle intervention showed significant benefit in risk factors that are known to be associated with development of cardiovascular disease in patients with type 2 diabetes. 2015 The Authors. PublishedbyElsevier Inc. This isan open access articleunder theCCBY-NC- ND license (nses/by-nc-nd/3.0/). T Continue reading >>

Lifestyle Intervention By Group-based Rehabilitation Versus Individual Counseling In Type 2 Diabetes: 1-year Follow-up Of The Copenhagen Type 2 Diabetes Rehabilitation Project

Lifestyle Intervention By Group-based Rehabilitation Versus Individual Counseling In Type 2 Diabetes: 1-year Follow-up Of The Copenhagen Type 2 Diabetes Rehabilitation Project

Lifestyle intervention by group-based rehabilitation versus individual counseling in type 2 diabetes: 1-year follow-up of the Copenhagen type 2 diabetes rehabilitation project Download as PDF (Size:366KB) PP. 308-315 DOI: 10.4236/jdm.2012.23048 3,033 Downloads 5,373 Views Citations Background: Today most guidelines on the management of type 2 diabetes incorporate lifestyle intervention including patient education, physical activity and dietary modification. However, the content and organization of lifestyle intervention programs are still debatable. Aims: To compare the longer term effectiveness of a group-based rehabilitation program with an individual counseling program at improving glycemic control, cardiovascular risk factors and quality of life among type 2 diabetes patients. Methods: We randomized 143 type 2 diabetes patients to either a 6-month group-based rehabilitation program, including patient education, supervised exercise, and diet intervention, or a 6-month individual counseling program. Follow-up time was 12 months after baseline. Outcome measures were glycated hemoglobin (HbA1c), cardiovascular risk factors, quality-of-life and self-rated health. Results: In the rehabilitation group, HbA1c decreased 0.2%-point (95% confidence interval [CI] = -0.4, -0.03), systolic blood pressure decreased 6 mmHg (95% CI = -9.3, -2.5), diastolic blood pressure decreased 4 mmHg (95% CI = -6.3, -2.4), weight decreased 2.2 kg (95% CI = -3.2, -1.3), and waist circumference decreased 2.0 cm (95% CI = -2.9, -1.1). In the individual group, HbA1c decreased 0.4% (95% CI = -0.6, -0.1), systolic blood pressure decreased 3 mmHg (95% CI = -6.3, -0.7), diastolic blood pressure decreased 3 mmHg (95% CI = -4.7, -0.7), weight decreased 1.6 kg (95% CI = -2.6, -.7]), and waist circumferenc Continue reading >>

Frontiers | Community-based Physical Activity Interventions For Treatment Of Type 2 Diabetes: A Systematic Review With Meta-analysis | Endocrinology

Frontiers | Community-based Physical Activity Interventions For Treatment Of Type 2 Diabetes: A Systematic Review With Meta-analysis | Endocrinology

Front. Endocrinol., 29 January 2013 | Community-based physical activity interventions for treatment of type 2 diabetes: a systematic review with meta-analysis 1Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW Australia 2Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada Evidence suggests engaging in regular physical activity (PA) can have beneficial outcomes for adults with type 2 diabetes (TD2), including weight loss, reduction of medication usage and improvements in hemoglobin A1c (HbA1c)/fasting glucose. While a number of clinical-based PA interventions exist, community-based approaches are limited. The objective of this study is to conduct a systematic review with meta-analysis to assess the effectiveness of community-based PA interventions for the treatment of TD2 in adult populations. A search of peer-reviewed publications from 2002 to June 2012 was conducted across several electronic databases to identify interventions evaluated in community settings. Twenty-two studies were identified, and 11 studies reporting HbA1c as an outcome measure were pooled in the meta-analysis. Risk of bias assessment was also conducted. The findings demonstrate community-based PA interventions can be effective in producing increases in PA. Meta-analysis revealed a lowering of HbA1c levels by 0.32% [95% CI 0.65, 0.01], which approached statistical significance (p < 0.06). Our findings can guide future PA community-based interventions in adult populations diagnosed with TD2. The estimated global prevalence of diabetes in 2010 was 6.4% (equating to 285 million adults). Type two diabetes (T2D) has contributed to the majority of these cases ( Shaw et al., 2010 ). T2D is largely related to weight gai Continue reading >>

Vm -- Type 2 Diabetes: Lifestyle Changes And Drug Treatment, Mar 09 ... Virtual Mentor

Vm -- Type 2 Diabetes: Lifestyle Changes And Drug Treatment, Mar 09 ... Virtual Mentor

Type 2 Diabetes: Lifestyle Changes and Drug Treatment The principal therapies for type 2 diabetes and the benefits and possible side effects associated with each. More than 23 million individuals in the United States have diabetesa figure that creates great urgency for finding the most effective and safest methods for treatment. Data show that therapies that lower hyperglycemia to the normoglycemic range can reduce morbidity, cardiovascular mortality, and microvascular complications in type 1 diabetes [1-3]. Likewise, intensive treatment strategies for type 2 diabetes have demonstrated a reduction in microvascular disease, but more recent data show no reduction in macrovascular disease [4-7]. Due to the potential for complications, initial treatment for decreasing hyperglycemia should be patient-specific and adjusted to achieve the American Diabetes Association (ADA) target A1c level of less than 7 percent [8]. While oral and injectable pharmacotherapies and insulin are often needed to maintain this level, the importance and benefit of lifestyle changes should not be undervalued. According to the 2008 consensus statement from the ADA and European Association for the Study of Diabetes, lifestyle interventions and metformin therapy should be started concurrently upon diagnosis of type 2 diabetes [9]. Learning Objective Identify principal therapies for type 2 diabetes and understand the benefits and potential side effects associated with each. In selecting treatment for chronic disease, the mechanism of the disease should be considered. Obesity and a sedentary lifestyle, for example, contribute to the risk for and development of type 2 diabetes. Obesity is also a factor in insulin resistance, which is a major cause of elevated glucose levels. Weight reduction and an incre Continue reading >>

Lifestyle Interventions For Patients With And At Risk For Type 2 Diabetes: A Systematic Review And Meta-analysis Free

Lifestyle Interventions For Patients With And At Risk For Type 2 Diabetes: A Systematic Review And Meta-analysis Free

Article, Author, and Disclosure Information Author, Article, and Disclosure Information From the University of Alberta Evidence-based Practice Center and Alberta Research Centre for Health Evidence, University of Alberta, Edmonton, Alberta, Canada. Disclaimer: The findings and conclusions in this article are those of the authors, who are responsible for its content, and do not necessarily represent the views of the Agency for Healthcare Research and Quality. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. Acknowledgment: The authors thank the following persons for their contributions: Carol Spooner (screening, data extraction, and research support), Tamara Durec (searching), Andrea Milne (searching), and Teodora Radisic (article retrieval). Grant Support: By the Agency for Healthcare Research and Quality (contract 290-2007-10021-I). Potential Conflicts of Interest: Mr. Vandermeer: Grant: Agency for Healthcare Research and Quality. Dr. Korownyk: Grant: Agency for Healthcare Research and Quality. All other authors have no disclosures. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0950 . Requests for Single Reprints: Christina Korownyk, MD, CCFP, Department of Family Medicine, 1706 College Plaza, 8215 112 Street, University of Alberta, Edmonton, Alberta T6G 2C8, Canada; e-mail, [email protected] . Current Author Addresses: Ms. Sumamo Schellenberg: Edmonton Clinic Health Academy, 4-88D, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Dr. Dryden: Edmonton Clinic Health Academy, 4-474, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Mr. Van Continue reading >>

Peer Support Interventions For Adults With Diabetes: A Meta-analysis Of Hemoglobin A1c Outcomes

Peer Support Interventions For Adults With Diabetes: A Meta-analysis Of Hemoglobin A1c Outcomes

Peer Support Interventions for Adults With Diabetes: A Meta-Analysis of Hemoglobin A1c Outcomes 1Department of Family and Community Medicine, University of Missouri, Columbia, Missouri 2Sinclair School of Nursing, University of Missouri, Columbia, Missouri CORRESPONDING AUTHOR: Sonal J. Patil, MD, Curtis W. and Ann H. Long Department of Family and Community Medicine, MA306 Medical Sciences Building, DC032.00, University of Missouri Columbia, MO 65212, patilso{at}health.missouri.edu PURPOSE Peer support intervention trials have shown varying effects on glycemic control. We aimed to estimate the effect of peer support interventions delivered by people affected by diabetes (those with the disease or a caregiver) on hemoglobin A1c (HbA1c) levels in adults. METHODS We searched multiple databases from 1960 to November 2015, including Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, CINAHL, and Scopus. We included randomized controlled trials (RCTs) of adults with diabetes receiving peer support interventions compared with otherwise similar care. Seventeen of 205 retrieved studies were eligible for inclusion. Quality was assessed with the Cochrane risk of bias tool. We calculated the standardized mean difference (SMD) of change in HbA1c level from baseline between groups using a random effects model. Subgroup analyses were predefined. RESULTS Seventeen studies (3 cluster RCTs, 14 RCTs) with 4,715 participants showed an improvement in pooled HbA1c level with an SMD of 0.121 (95% CI, 0.0260.217; P = .01; I2 = 60.66%) in the peer support intervention group compared with the control group; this difference translated to an improvement in HbA1c level of 0.24% (95% CI, 0.05%0.43%). Peer support interventions showed an HbA1c improvement of 0.48% (95% CI, 0.25%0.70%; Continue reading >>

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis.

Effect Of Lifestyle Intervention In Patients With Type 2 Diabetes: A Meta-analysis.

Metabolism. 2015 Feb;64(2):338-47. doi: 10.1016/j.metabol.2014.10.018. Epub 2014 Oct 23. Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. The First Division in Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou 510080, China. Electronic address: [email protected] The First Division in Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou 510080, China. The effect of lifestyle intervention on clinical risk factors in patients with type 2 diabetes is unclear. The aim of this meta-analysis was to evaluate the effects of comprehensive lifestyle change, such as diet, exercise, and education, on clinical markers that are risk-factors for cardiovascular disease in patients with type 2 diabetes. We searched Medline, Cochrane, EMBASE, and Google Scholar (up to August 31, 2013) for randomized controlled trials that compared standard of care (control group) with treatment regimens that included changes in lifestyle (intervention group). The primary outcome was reduction in risk factors of cardiovascular disease including body mass index (BMI), glycated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). A total of 16 studies were included in the meta-analysis. The standardized difference in means of change from baseline significantly favored the intervention compared with the control group in BMI (-0.29; 95% CI, -0.52 to -0.06, P=0.014), HbA1c (-0.37; 95% CI, -0.59 to -0.14, P=0.001), SBP (-0.16: 95% CI, -0.29 to -0.03, P=0.016), DBP (-0.27, 95% CI=-0.41 to Continue reading >>

More in diabetes