Global comparison of the effect of non-pharmacological interventions on glycemic control in patients with type 2 diabetes: A network meta-analysis from 107 randomized controlled trials |
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| Affiliation: | 1. Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China;2. Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong;3. School of Nursing, Tongji University, Shanghai 200000, China;4. Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China;5. School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China;1. Hypertension and Cardiovascular risk factors Research Centre, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy;2. PROMISE Department, School of Medicine, University of Palermo, Palermo, Italy;3. IRCCS AOU di Bologna, Bologna, Italy;1. School of Nursing, Weinan Vocational and Technical College, Weinan, Shaanxi, China;2. Third Department of Surgery, The First Hospital of Weinan City, Weinan, Shaanxi, China;3. Department of Endocrinology, The First People''s Hospital of Tai''an City, Tai''an, Shandong, China;1. Post-graduate Program in Biochemistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil;2. Post Graduate Program of Health, Welfare and Sustainable Animal Production on Fronteira Sul, Federal University of Fronteira Sul, Realeza, PR, Brazil;3. Multicentric Postgraduate Program in Biochemistry and Molecular Biology, State University of Santa Catarina, Lages, SC, Brazil;4. Post Graduate Program in Health Sciences of the Community University of Chapecó Region - Unochapecó, Chapecó, SC, Brazil;5. School of Health, Area of Biological and Health Sciences, Community University of Chapecó Region - Unochapecó, Chapecó, SC, Brazil;6. Graduate Program in Chemical Engineering, Federal University of Santa Maria, Santa Maria, RS, Brazil;7. Department of Chemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil;8. Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, RS, Brazil;9. Post Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil |
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| Abstract: | ObjectiveTo investigate the effectiveness of non-pharmacological interventions (NPIs) on glycemic control in patients with type 2 diabetes (T2D) and to provide guidance for clinical healthcare-giver.DesignNetwork meta-analysis (NMA).Setting and participantsRandomized controlled trials comparing the effect of NPIs with usual care, waitlist, or other NPIs on glycemic control in patients with T2D.MethodsThis NMA was guided by frequentist framework. PubMed, Embase, the Cochrane Library Central Register of Controlled Trials, Cumulated Index to Nursing and Allied Health Literature, and Web of Science were searched from their inception until January 2023. The primary outcome was HbA1c and secondary outcomes were cardiovascular risk scores and related psychosocial scores. Mean differences and standardized mean differences were pooled using NMA. Study quality was assessed with the Confidence in Network Meta-analysis.ResultsA total of 107 studies (10,496 participants) were included. The median sample size of the included studies was 64 (range, 10–563) and the median duration was 3 months (range, 1–24). Compared to usual care, all NPIs except acupuncture (MD: −0.28; 95 % CI: −1.02, 0.26) and psychological therapy (MD: −0.29; 95 % CI: −0.66, 0.08) showed significantly differences in improving glycemic control in patients with T2D. And according to the results of surface under the cumulative ranking analysis and Cluster ranking, meditation therapy was considered to the best choice when balancing the efficacy of glycemic control with self-efficacy and diabetes related problems, while nutrition therapy was considered to the best choice when balancing quality of life with risk of cardiovascular complications.ConclusionsThese findings validate the efficacy of NPIs for glycemic control in patients with T2D and suggest that healthcare-giver should consider both the efficacy of interventions and the psychosocial needs of patients when developing NPIs programs. |
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