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Systematic Review On Diabetes

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A Review Of Systematic Reviews Evaluating Diabetes Interventions

A Review Of Systematic Reviews Evaluating Diabetes Interventions

A Review of Systematic Reviews Evaluating Diabetes Interventions Gayenell S. Magwood , PhD, MSN, RN, Jane Zapka , ScD, and Carolyn Jenkins , DrPH, APRN-BCDM, CDE, RD, FAAN College of Nursing (GSM, JZ, CJ) and the Department of Biostatistics, Bioinformatics and Epidemiology (JZ), Medical University of South Carolina, Charleston. Sponsored research: Resource Center for Minority Aging Research (RCMAR), National Institute on Aging, P30AG21677, Dr Barbara Tilley, principal investigator (PI); Racial and Ethnic Approaches to Community Health (REACH), Centers for Disease Control and Prevention, U50/CCU422184-04, Dr Carolyn Jenkins, PI Correspondence to Gayenell S. Magwood, PhD, MSN, RN, Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, PO Box 250160, Charleston, SC 29425 ( ude.csum@gdoowgam ). The publisher's final edited version of this article is available at Diabetes Educ See other articles in PMC that cite the published article. This article reviews the literature on definitions and issues related to measurement of quality of life in people with diabetes and summarizes reviews of evidence of intervention studies, with a particular focus on interventions targeted for underserved and minority populations. An integrative literature review of reviews was conducted on adult diabetes interventions and outcomes. Five electronic databases were searched. Eligible publications were those published between 1999 and 2006 that described outcome measures. Twelve review articles are included. Review studies were heterogeneous in terms of intervention type, content, participants, setting, and outcome measures. Interventions used variable operational definitions and frequently lacked adequate description; therefore, comparisons of findings proved difficult Continue reading >>

Lifestyle Interventions To Prevent Type 2 Diabetes: A Systematic Review Of Economic Evaluation Studies

Lifestyle Interventions To Prevent Type 2 Diabetes: A Systematic Review Of Economic Evaluation Studies

Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies Koffi Alouki ,1 Hlne Delisle ,1 Clara Bermdez-Tamayo ,2and Mira Johri 3,4 1TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, 2405 Chemin de la Cte Sainte-Catherine, Montreal, QC, Canada H3T 1A8 2Institut de Recherche en Sant Publique de lUniversit de Montral (IRSPUM), University of Montreal, 7101 Avenue du Parc, 3e tage, Montral, QC, Canada H3N 1X9 3Centre de Recherche du Centre Hospitalier de lUniversit de Montral (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, Montral, QC, Canada H2X 0A9 4Department of Health Administration, School of Public Health (ESPUM), Faculty of Medicine, University of Montreal, 7101 Avenue du Parc, 3e tage, Montral, QC, Canada H3N 1X9 Received 17 July 2015; Revised 13 October 2015; Accepted 19 October 2015 Copyright 2016 Koffi Alouki 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. Objective. To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of type 2 diabetes (T2D) in high-risk subjects. Methods. We conducted a systematic review of peer-reviewed original studies published since January 2009 in English, French, and Spanish. Eligible studies were identified through relevant databases including PubMed, Medline, National Health Services Economic Evaluation, CINHAL, EconLit, Web of sciences, EMBASE, and the Latin American and Caribbean Health Sciences Literature. Studies targeting obesity were also included. Data were extracted Continue reading >>

A Systematic Review Of Biomarkers And Risk Of Incident Type 2 Diabetes: An Overview Of Epidemiological, Prediction And Aetiological Research Literature

A Systematic Review Of Biomarkers And Risk Of Incident Type 2 Diabetes: An Overview Of Epidemiological, Prediction And Aetiological Research Literature

Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click here . A Systematic Review of Biomarkers and Risk of Incident Type 2 Diabetes: An Overview of Epidemiological, Prediction and Aetiological Research Literature Affiliation Medical Research Council (MRC) Epidemiology Unit, University of Cambridge School of Clinical, Cambridge, United Kingdom Affiliation GlaxoSmithKline, R&D, Stevenage, United Kingdom, RTP NC, King of Prussia, PA, United States of America Affiliation Medical Research Council (MRC) Epidemiology Unit, University of Cambridge School of Clinical, Cambridge, United Kingdom Affiliation Pfizer Inc, Cambridge, MA, United States of America Affiliation Department of Medicine, Internal Medicine, CHUV, Lausanne, Switzerland Affiliation Medical Research Council (MRC) Epidemiology Unit, University of Cambridge School of Clinical, Cambridge, United Kingdom Affiliation GlaxoSmithKline, R&D, Stevenage, United Kingdom, RTP NC, King of Prussia, PA, United States of America Affiliation GlaxoSmithKline, R&D, Stevenage, United Kingdom, RTP NC, King of Prussia, PA, United States of America Affiliation Medical Research Council (MRC) Epidemiology Unit, University of Cambridge School of Clinical, Cambridge, United Kingdom Affiliation Medical Research Council (MRC) Epidemiology Unit, University of Cambridge School of Clinical, Cambridge, United Kingdom Continue reading >>

Diabetes And Risk Of Physical Disability In Adults: A Systematic Review And Meta-analysis

Diabetes And Risk Of Physical Disability In Adults: A Systematic Review And Meta-analysis

Summary According to previous reports, the risk of disability as a result of diabetes varies from none to double. Disability is an important measure of health and an estimate of the risk of disability as a result of diabetes is crucial in view of the global diabetes epidemic. We did a systematic review and meta-analysis to estimate this risk. We searched Ovid, Medline, Embase, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature up to Aug 8, 2012. We included studies of adults that compared the risk of disability—as measured by activities of daily living (ADL), instrumental activities of daily living (IADL), or mobility—in people with and without any type of diabetes. We excluded studies of subpopulations with specific illnesses or of people in nursing homes. From the studies, we recorded population characteristics, how diabetes was diagnosed (by doctor or self-reported), domain and definition of disability, and risk estimates for disability. We calculated pooled estimates by disability type and type of risk estimate (odds ratio [OR] or risk ratio [RR]). Our systematic review returned 3224 results, from which 26 studies were included in our meta-analyses. Diabetes increased the risk of mobility disability (15 studies; OR 1·71, 95% CI 1·53–1·91; RR 1·51, 95% CI 1·38–1·64), of IADL disability (ten studies; OR 1·65, 95% CI 1·55–1·74), and of ADL disability (16 studies; OR 1·82, 95% CI 1·63–2·04; RR 1·82, 95% CI 1·40–2·36). Diabetes is associated with a strong increase in the risk of physical disability. Efforts to promote healthy ageing should account for this risk through prevention and management of diabetes. Monash University, Baker IDI Bright Sparks Foundation, Australian Postgraduate Award, VicHealth, National Hea Continue reading >>

Effect Of Telemedicine On Glycated Hemoglobin In Diabetes: A Systematic Review And Meta-analysis Of Randomized Trials

Effect Of Telemedicine On Glycated Hemoglobin In Diabetes: A Systematic Review And Meta-analysis Of Randomized Trials

Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials Labib Imran Faruque, Natasha Wiebe, Arash Ehteshami-Afshar, Yuanchen Liu, Neda Dianati-Maleki, Brenda R. Hemmelgarn, Braden J. Manns, Marcello Tonelli and for the Alberta Kidney Disease Network CMAJ October 31, 2016 cmaj.150885; DOI: To view full-text articles published before 1997, see PubMed Central. Background: Telemedicine, the use of telecommunications to deliver health services, expertise and information, is a promising but unproven tool for improving the quality of diabetes care. We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care. Methods: We searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases (to November 2015) and reference lists of existing systematic reviews for randomized controlled trials (RCTs) comparing telemedicine with usual care for adults with diabetes. Two independent reviewers selected the studies and assessed risk of bias in the studies. The primary outcome was glycated hemoglobin (HbA1C) reported at 3 time points ( 3 mo, 4-12 mo and > 12 mo). Other outcomes were quality of life, mortality and episodes of hypoglycemia. Trials were pooled using random-effects meta-analysis, and heterogeneity was quantified using the I2 statistic. Results: From 3688 citations, we identified 111 eligible RCTs (n = 23648). Telemedicine achieved significant but modest reductions in HbA1C in all 3 follow-up periods (difference in mean at 3 mo: 0.57%, 95% confidence interval [CI] 0.74% to 0.40% [39 trials]; at 4-12 mo: 0.28%, 95% CI 0.37% to 0.20% [87 trials]; and at > 12 mo: 0.26%, 95% CI 0.46% to 0.06% [5 trials]). Quantified heterogeneity (I2 Continue reading >>

Exercise For Type 2 Diabetes Mellitus

Exercise For Type 2 Diabetes Mellitus

Exercise, dietary changes and medications are frequently used in the management of type 2 diabetes. However, it is difficult to determine the independent effect of exercise from some trials because exercise has been combined with dietary modifications or medications, or compared with a control which includes another form of intervention. The review authors aimed to determine the effect of exercise on blood sugar control in type 2 diabetes. This review found that exercise improves blood sugar control and that this effect is evident even without weight loss. Furthermore, exercise decreases body fat content, thus the failure to lose weight with exercise programmes is probably explained by the conversion of fat to muscle. Exercise improved the body's reaction to insulin and decreased blood lipids. Quality of life was only assessed in one study, which found no difference between the two groups. No significant difference was found between groups in blood levels of cholesterol or blood pressure. A total of 14 randomised controlled trials were assessed. These included 377 participants and compared groups that differed only with respect to an exercise programme intervention. The duration of the interventions in the studies ranged from eight weeks to one year. Two studies reported follow-up information, one at six months after the end of the six month exercise intervention and one at twelve months post-intervention. Generally, the studies were well-conducted, but blinding of outcome assessors was not reported and although all studies reported that randomisation was performed, few gave details of the method. No adverse effects with exercise were reported. The effect of exercise on diabetic complications was not assessed in any of the studies. The relatively short duration of trial Continue reading >>

A Systematic Review And Meta-analysis Of Exercise Interventions In Adults With Type 1 Diabetes

A Systematic Review And Meta-analysis Of Exercise Interventions In Adults With Type 1 Diabetes

Volume 106, Issue 3 , December 2014, Pages 393-400 A systematic review and meta-analysis of exercise interventions in adults with type 1 diabetes There are few published randomized controlled trials of exercise in type 1 diabetes. Of those that are published, few meet the methodological rigor currently expected of randomized trials. The results of existing trials are promising, but insufficient for ascertaining the effect of exercise training on HbA1c. Conflicting evidence exists regarding the benefits of physical activity for long-term blood glucose control in adults with type 1 diabetes (T1D). The object of this systematic review was to determine the effects of physical activity on long-term blood glucose control in T1D adults. PubMed/Medline, Embase, CENTRAL, SPORTdiscus, Global Health and ICTRP were searched up to October 2013 for randomized trials of aerobic or resistance exercise training in T1D adults. Exercises had to be performed at least twice weekly for a minimum of two months. The primary outcome was glycated hemoglobin (HbA1c). Secondary outcomes included cardiorespiratory fitness and insulin dose. Six randomized trials were identified (323 adults); sample sizes ranged from n=6 to n=148 participants receiving the intervention. Five trials had an unknown risk of bias; one trial was deemed to be at high risk of bias. Exercise frequency varied from twice weekly to daily, with intensities (5090% VO2peak), and session durations (20120min) varying widely. Four trials reported HbA1c, which decreased with exercise training (mean difference [MD] 0.78% (9mmol/mol), 95% CI 1.14 (13mmol/mol) to 0.41 (5mmol/mol); p<0.0001; I2 0%) compared with controls. Exercise training improved cardiorespiratory fitness by 3.45ml/kg/min (95% CI 0.59 to 6.31, p=0.02, I2 0%) compared w Continue reading >>

Improving Quality Of Care For Persons With Diabetes: An Overview Of Systematic Reviews - What Does The Evidence Tell Us?

Improving Quality Of Care For Persons With Diabetes: An Overview Of Systematic Reviews - What Does The Evidence Tell Us?

Improving quality of care for persons with diabetes: an overview of systematic reviews - what does the evidence tell us? Worswick et al.; licensee BioMed Central Ltd.2013 Ensuring high quality care for persons with diabetes remains a challenge for healthcare systems globally with consistent evidence of suboptimal care and outcomes. There is increasing interest in quality improvement strategies to improve diabetes management as reflected by a growing number of systematic reviews. These reviews are of varying quality and dispersed across many sources. In this paper, we present an overview of systematic reviews evaluating the impact of interventions to improve the quality of diabetes care. We searched for systematic reviews evaluating the effectiveness of any intervention intended to improve intermediate patient outcomes and process of care measures for patients with any type of diabetes. Two reviewers independently screened search results, appraised each systematic review using AMSTAR and extracted data from high quality reviews (AMSTAR score 5). Within reviews, we used vote counting by direction of effect to report the number of studies favouring an intervention for each outcome. We produced summaries of results for each intervention category. We identified 125 reviews of varying methodological quality and summarised key findings from 50 high quality reviews. We categorised reviews by quality improvement intervention. Eight reviews were broad based (involving a variety of strategies). Other reviews considered: patient education and support (n = 21), telemedicine (n = 10), provider role changes (n = 7), and organisational changes (n = 4). Reviews reported intermediate patient outcomes (e.g. glycaemic control) (n = 49) and process of care outcomes (n = 9). There was evide Continue reading >>

Physical Activity And Incident Type 2 Diabetes Mellitus: A Systematic Review And Doseresponse Meta-analysis Of Prospective Cohort Studies

Physical Activity And Incident Type 2 Diabetes Mellitus: A Systematic Review And Doseresponse Meta-analysis Of Prospective Cohort Studies

, Volume 59, Issue12 , pp 25272545 | Cite as Physical activity and incident type 2 diabetes mellitus: a systematic review and doseresponse meta-analysis of prospective cohort studies Inverse associations between physical activity (PA) and type 2 diabetes mellitus are well known. However, the shape of the doseresponse relationship is still uncertain. This review synthesises results from longitudinal studies in general populations and uses non-linear models of the association between PA and incident type 2 diabetes. A systematic literature search identified 28 prospective studies on leisure-time PA (LTPA) or total PA and risk of type 2 diabetes. PA exposures were converted into metabolic equivalent of task (MET) h/week and marginal MET (MMET) h/week, a measure only considering energy expended above resting metabolic rate. Restricted cubic splines were used to model the exposuredisease relationship. Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 METh/week (equivalent to 150min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 METh/week, risk reduction of 53%). Results for the MMETh/week doseresponse curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity. Higher levels of LTPA were associated with substantially lower incidence of type 2 diabetes in the general population. The relationship between LTPA and type 2 diabetes was curvilinear; the greatest relative benefits are achieved at low levels of activity Continue reading >>

Jmu-efficacy Of Mobile Apps To Support The Care Of Patients With Diabetes Mellitus: A Systematic Review And Meta-analysis Of Randomized Controlled Trials | Bonoto | Jmir Mhealth And Uhealth

Jmu-efficacy Of Mobile Apps To Support The Care Of Patients With Diabetes Mellitus: A Systematic Review And Meta-analysis Of Randomized Controlled Trials | Bonoto | Jmir Mhealth And Uhealth

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 Jul 04, 2016. This paper is in the following e-collection/theme issue: Efficacy of Mobile Apps to Support the Care of Patients With Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 1Post Graduate Program in Medicines and Pharmaceutical Assistance, Department of Social Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil 2Institute of Biological Sciences and Health, Faculty of Odontology, Pontifcia Universidade Catlica de Minas Gerais, Belo Horizonte, Brazil 3SUS Collaborating Centre for Technology Assessment and Excellence in Health, Department of Social Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil 4Post Graduate Program in Public Health, Department Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil 5Institute of Pharmacy and Biomedical Sciences, University of Strathclyde Glasgow, Glasgow, United Kingdom 6Division of Clinical Pharmaclogy, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden 7Department of Clinical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil Post Graduate Program in Medicines and Pharmaceutical Assistance Background: Diabetes Mellitus (DM) is a chronic disease that is considered a global public health problem. Education and self-monitoring by diabetic patients help to optimize and make possible a satisfactory metabolic control enabling improved management and reduced morbidity and mortality. Th Continue reading >>

Efficacy And Effectiveness Of Screen And Treat Policies In Prevention Of Type 2 Diabetes: Systematic Review And Meta-analysis Of Screening Tests And Interventions

Efficacy And Effectiveness Of Screen And Treat Policies In Prevention Of Type 2 Diabetes: Systematic Review And Meta-analysis Of Screening Tests And Interventions

Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions BMJ 2017; 356 doi: (Published 04 January 2017) Cite this as: BMJ 2017;356:i6538 Eleanor Barry, NIHR in-practice fellow 1 , Shanti Vijayaraghavan, consultant diabetologist 2 , Rebecca Normansell, deputy co-ordinating editor Cochrane Airways Group 3 , 1Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, University of Oxford, Oxford OX2 6GG, UK 2Department of Diabetes, Newham University Hospital, Barts Health NHS Trust, London, UK 3Population Health Research Institute, St Georges University of London, London SW17 0RE, UK Correspondence to: E Barry Eleanor.barry{at}phc.ox.ac.uk ObjectivesTo assess diagnostic accuracy of screening tests for pre-diabetes and efficacy of interventions (lifestyle or metformin) in preventing onset of type 2 diabetes in people with pre-diabetes. DesignSystematic review and meta-analysis. Data sources and methodMedline, PreMedline, and Embase. Study protocols and seminal papers were citation-tracked in Google Scholar to identify definitive trials and additional publications. Data on study design, methods, and findings were extracted onto Excel spreadsheets; a 20% sample was checked by a second researcher. Data extracted for screening tests included diagnostic accuracy and population prevalence. Two meta-analyses were performed, one summarising accuracy of screening tests (with the oral glucose tolerance test as the standard) for identification of pre-diabetes, an Continue reading >>

Diabetes Mellitus And Risk Of Falls In Older Adults: A Systematic Review And Meta-analysis

Diabetes Mellitus And Risk Of Falls In Older Adults: A Systematic Review And Meta-analysis

Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis Department of Vascular and Thyroid Surgery Department of Vascular and Thyroid Surgery Department of Vascular and Thyroid Surgery Department of Vascular and Thyroid Surgery Age and Ageing, Volume 45, Issue 6, 2 November 2016, Pages 761767, Yu Yang, Xinhua Hu, Qiang Zhang, Rui Zou; Diabetes mellitus and risk of falls in older adults: a systematic review and meta-analysis, Age and Ageing, Volume 45, Issue 6, 2 November 2016, Pages 761767, intensive or very loose glycemic control may contribute to the risk of falls in diabetic patients. However, studies on diabetes mellitus and the risk of falls have yielded conflicting results. Our objective was to investigate the effect of diabetes mellitus on the risk of falls in older adults by conducting a systematic review and meta-analysis. the PubMed and Embase databases were searched for relevant studies published until November 2015. Only prospective cohort studies reporting at least age-adjusted risk estimate of falls compared diabetic to non-diabetic individuals were selected. Diabetes mellitus was ascertained by a combination of medical history and laboratory tests or use of anti-diabetic drugs. a total of six studies involving 14,685 participants were identified. The number of falls in diabetic and non-diabetic individuals was 423 of 1,692 (25.0%) and 2,368 of 13,011 (18.2%), respectively. Diabetes mellitus was associated with an increased risk of falls (risk ratio [RR]=1.64; 95% confidence intervals [CI] 1.272.11) in a random-effects model. Subgroup analyses showed that the risk of falls seemed more pronounced among both gender groups (RR=1.81; 95% CI 1.192.76) than among women (RR=1.52; 95% CI 1.042.21). Diabetes increased 94% (RR=1.9 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 >>

A Systematic Review Of Real-world Diabetes Prevention Programs: Learnings From The Last 15years

A Systematic Review Of Real-world Diabetes Prevention Programs: Learnings From The Last 15years

A systematic review of real-world diabetes prevention programs: learnings from the last 15years The evidence base for the prevention of type 2 diabetes mellitus (T2DM) has progressed rapidly from efficacy trials to real-world translational studies and practical implementation trials over the last 15years. However, evidence for the effective implementation and translation of diabetes programs and their population impact needs to be established in ways that are different from measuring program effectiveness. We report the findings of a systematic review that focuses on identifying the critical success factors for implementing diabetes prevention programs in real-world settings. A systematic review of programs aimed at diabetes prevention was undertaken in order to evaluate their outcomes using the penetration, implementation, participation, and effectiveness (PIPE) impact metric. A search for relevant articles was carried out using PubMed (March 2015) and Web of Science, MEDLINE, CENTRAL, and EMBASE. A quality coding system was developed and included studies were rated independently by three researchers. Thirty eight studies were included in the review. Almost all (92%) provided details on participation; however, only 18% reported the coverage of their target population (penetration). Program intensity or implementationas measured by frequency of contacts during first year and intervention durationwas identified in all of the reported studies, and 84% of the studies also reported implementation fidelity; however, only 18% of studies employed quality assurance measures to assess the extent to which the program was delivered as planned. Sixteen and 26% of studies reported highly or moderately positive changes (effectiveness) respectively, based on weight loss. Six (16%) st Continue reading >>

A Systematic Review Of Interventions To Improve Diabetes Care In Sociallydisadvantaged Populations.

A Systematic Review Of Interventions To Improve Diabetes Care In Sociallydisadvantaged Populations.

1. Diabetes Care. 2006 Jul;29(7):1675-88. A systematic review of interventions to improve diabetes care in sociallydisadvantaged populations. Glazier RH(1), Bajcar J, Kennie NR, Willson K. (1)Centre for Research on Inner City Health, St. Michael's Hospital, 30 Bond St., Toronto, Ontario, Canada. [email protected] OBJECTIVE: To identify and synthesize evidence about the effectiveness ofpatient, provider, and health system interventions to improve diabetes care amongsocially disadvantaged populations.RESEARCH DESIGN AND METHODS: Studies that were included targeted interventionstoward socially disadvantaged adults with type 1 or type 2 diabetes; wereconducted in industrialized countries; were measured outcomes of self-management,provider management, or clinical outcomes; and were randomized controlled trials,controlled trials, or before-and-after studies with a contemporaneous controlgroup. Seven databases were searched for articles published in any languagebetween January 1986 and December 2004. Twenty-six intervention features wereidentified and analyzed in terms of their association with successful orunsuccessful interventions.RESULTS: Eleven of 17 studies that met inclusion criteria had positive results.Features that appeared to have the most consistent positive effects includedcultural tailoring of the intervention, community educators or lay people leadingthe intervention, one-on-one interventions with individualized assessment andreassessment, incorporating treatment algorithms, focusing on behavior-relatedtasks, providing feedback, and high-intensity interventions (>10 contact times)delivered over a long duration (>or=6 months). Interventions that wereconsistently associated with the largest negative outcomes included those thatused mainly didactic teach Continue reading >>

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