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Behavioral Programs for Type 1 Diabetes Mellitus: A Systematic Review and Meta-analysis
- Source :
- Annals of internal medicine. 163(11)
- Publication Year :
- 2015
-
Abstract
- Background Whether behavioral approaches for self-management programs benefit individuals with type 1 diabetes mellitus is unclear. Purpose To determine the effects of behavioral programs for patients with type 1 diabetes on behavioral, clinical, and health outcomes and to investigate factors that might moderate effect. Data sources 6 electronic databases (1993 to June 2015), trial registries and conference proceedings (2011 to 2014), and reference lists. Study selection 36 prospective, controlled studies involving participants of any age group that compared behavioral programs with usual care, active controls, or other programs. Data extraction One reviewer extracted and another verified data. Two reviewers assessed quality and strength of evidence (SOE). Data synthesis Moderate SOE showed reduction in glycated hemoglobin (HbA1c) at 6 months after the intervention compared with usual care (mean difference, -0.29 [95% CI, -0.45 to -0.13] percentage points) and compared with active controls (-0.44 [CI, -0.69 to -0.19] percentage points). At the end of the intervention and 12-month follow-up or longer, there were no statistically significant differences in HbA1c (low SOE) for comparisons with usual care or active control. Compared with usual care, generic quality of life at program completion did not differ (moderate SOE). Other outcomes had low or insufficient SOE. Adults appeared to benefit more for glycemic control at program completion (-0.28 [CI, -0.57 to 0.01] percentage points) than did youth (-0.12 [CI, -0.43 to 0.19] percentage points). Program intensity appeared not to influence effectiveness; some individual delivery appears beneficial. Limitations All studies had medium or high risk of bias. There was scarce evidence for many outcomes. Conclusion Behavioral programs for type 1 diabetes offer some benefit for glycemic control, at least at short-term follow-up, but improvement for other outcomes has not been shown. (PROSPERO registration number: CRD42014010515). Primary funding source Agency for Healthcare Research and Quality. (PROSPERD registration number: CRD42014010515).
- Subjects :
- medicine.medical_specialty
Health Behavior
MEDLINE
chemistry.chemical_compound
Quality of life (healthcare)
Patient Education as Topic
Health care
Internal Medicine
medicine
Humans
Life Style
Glycemic
Glycated Hemoglobin
Type 1 diabetes
business.industry
General Medicine
medicine.disease
Self Care
Diabetes Mellitus, Type 1
Data extraction
chemistry
Meta-analysis
Physical therapy
Quality of Life
Glycated hemoglobin
business
Subjects
Details
- ISSN :
- 15393704
- Volume :
- 163
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Annals of internal medicine
- Accession number :
- edsair.doi.dedup.....f058a43eb8e21873ab9d6f48c6b8198f