A study published in the journal ‘Annals of Internal Medicine’ has found behavioral programs may improve outcomes for individuals with type 2 diabetes.
But it also identified that there is a large diversity of behavioral interventions and uncertainty about how to maximise the effectiveness of these programs.
The research was conducted via systematic review and meta-analysis and aimed to identify factors moderating the effectiveness of behavioral programs for adults with type 2 diabetes.
The behavioural programmes were grouped on the basis of program content and delivery methods.
A meta-analysis showed that most lifestyle and diabetes self-management education and support programs (usually offering 11 or more contact hours) led to clinically important improvements in glycemic control, whereas most diabetes self-management education programs without added support – especially those offering 10 or fewer contact hours – provided little benefit.
Programs with greater impact were more often delivered in person than via technology.
Lifestyle programs led to the greatest reductions in body mass index.
Behavioral programs seem to benefit persons with suboptimal or poor glycemic control more than those with good control.
Programmes with a high proportion of ethnic minority participants (subgroups with ≥75% non-white participants) also performed well. The researchers highlight that many trials with a large proportion of ethnic minorities also adapted programs to make them more culturally and linguistically acceptable – often by including peers in the delivery or implementing social support groups – which may have enhanced their effectiveness.
Greater effect was seen in adults younger than 65 years and the researchers suggest that tailoring of programs to older adults is needed.
You can read the full article here.
Pillay J, Armstrong MJ, Butalia S, Donovan LE, Sigal RJ, Vandermeer B, et al. Behavioral Programs for Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis for Effect Moderation. Ann Intern Med. [Epub ahead of print 29 September 2015] doi:10.7326/M15-1400