Behavioral Programs for Diabetes Mellitus

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Table 12. Network meta-analysis for effect moderation on HbA 1c results in T2DM: description of nodes and results (continued) Rank Order of Effect, Method of Delivery Delivery MD (%HbA Arm Description Studies & Sample Size Intensity 1c), 95% Communication Method Personnel Credibility Interval of Study Arms DSME 19 135,153,154,178,185,212,225,23 1,234,238,243,244,257 N= 1,161 22 107,144,146,172,173,182,199,21 1,212,234 N = 1,160 29 144 N = 40 27 171,175,179,185,203,226,241,25 9,265 N = 532 26 168,176,177,183,194,218- 220,247,253 N = 1,679 24 192,206,213 N = 222 21 136,141,155,158,163,170,181,19 2,193,199,223,224,235,243,260,264 N = 1,216 20 195,196,228,229,246 N = 531 25 139,142,147,162,258 N = 611 5 197,233 N = 159 28 293 N = 46 7 215 N= 15 1 201,202,244 271 11 198 N = 30 ≤10h In person Individual & mixed HCP -0.29 [-0.61, 0.04] 0.0% ≤10h In person Group only HCP -0.22 [-0.61, 0.16] 0.0% ≤10h In person Group only Non-HCP -0.05 [-1.27, 1.16] 0.9% ≤10h Some technology Individual & mixed ≤10h Some technology Individual & mixed HCP -0.11 [-0.50, 0.27] 0.0% Non-HCP -0.16 [-0.53, 0.21] 0.0% 11-26h In person Individual & HCP -0.17 [-0.81, 0.47] 0.0% mixed 11-26h In person Group only HCP -0.25 [-0.53, 0.04] 0.0% 11-26h In person Group only Non-HCP -0.27 [-0.76, 0.21] 0.0% 11-26h Some technology Individual & mixed HCP -0.17 [-0.66, 0.31] 0.0% 11-26h Some technology Individual & Non-HCP -0.78 [-1.57, 0.02] 3.7% a mixed 11-26h Some technology Group only HCP -0.09 [-1.39, 1.20] 1.5% ≥27h In person Individual & HCP -0.73 [-1.86, 0.41] 8.1% a mixed ≥27h In person Group only HCP -1.37 [-2.03, -0.71] 36.0% a ≥27h Some technology Individual & mixed HCP -0.49 [-1.69, 0.70] 4.0% a Probability of Being Best 64
Table 12. Network meta-analysis for effect moderation on HbA 1c results in T2DM: description of nodes and results (continued) Arm Description Rank Order of Effect, Method of Delivery Delivery MD (%HbA Studies & Sample Size Intensity 1c), 95% Probability of Communication Method Personnel Credibility Interval Being Best of Study Arms DSME + Support 8 210 ≤10h In person Individual & NA -0.70 [-1.80, 0.40] 6.8% a N = 90 mixed 34 152 ≤10h In person Group only NA 2.83 [1.22, 4.43] 0.0% N = 48 17 172,207,230 ≤10h Some technology Individual & NA -0.38 [-0.99, 0.23] 0.0% N = 334 mixed 14 164 11-26h In person Individual & NA -0.44 [-1.76, 0.86] 4.8% a N = 52 mixed 6 150,208,209 11-26h In person Group only NA -0.74 [-1.56, 0.08] 2.8% a N = 267 16 152,189,209,222 11-26h Some technology Individual & NA -0.39 [-1.06, 0.28] 0.1% N = 240 mixed 10 216,217 ≥27h In person Individual & NA -0.54 [-1.28, 0.20] 0.8% a N = 197 mixed 4 150,151 ≥27h In person Group only NA -0.88 [-1.86, 0.09] 9.4% a N = 230 Lifestyle 32 145,188,249 ≤10h In person Individual & NA 0.20 [-0.50, 0.92] 0.0% N = 171 mixed 13 156,186 ≤10h In person Group only NA -0.45 [-1.35, 0.45] 0.9% a N = 44 33 188 ≤10h Some technology Individual & NA 0.25 [-1.11, 1.62] 0.5% N = 67 mixed 12 165,184,190,191,232,236 11-26h In person Individual & NA -0.47 [-0.99, 0.05] 0.0% a N = 138 mixed 9 169,170,205,232,255 11-26h In person Group only NA -0.69 [-1.25, -0.12] 0.5% a N = 161 3 143,160 11-26h Some technology Individual & NA -0.91 [-1.72, -0.10] 7.4% a N = 76 mixed 23 254 11-26h Some technology Group only NA -0.20 [-1.28, 0.88] 0.9% N = 74 2 137,161,174,214,261 ≥27h In person Individual & NA -1.12 [-1.72, -0.53] 10.7% a N = 233 mixed 30 239,240 ≥27h In person Group only NA 0.07 [-0.67, 0.83] 0.0% N = 305 18 166,252,262 ≥27h Some technology Individual & NA -0.37 [-1.01, 0.27] 0.1% N = 2643 mixed DSME = diabetes self-management education; h = hour(s); HbA 1c = hemoglobin A 1c ; HCP = health care professional; MD = mean difference; NA = not applicable a Highlighted rows represent those nodes having effect sizes meeting or exceeding our criteria for clinical importance. 65
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Evidence Report/Technology Assessme
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This report is based on research co
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Key Informants In designing the stu
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Peer Reviewers Prior to publication
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HbA 1c reduction were more often de
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KQ 6. Subgroups for Factors Moderat
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Figure 13. Behavioral programs for
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glycemia in reducing the incidence
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together with one or more additiona
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Figure A. Analytic framework for be
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Methods Literature Search Strategy
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With input from our Technical Exper
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participants had suboptimal baselin
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duration of diabetes ranged from 2.
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Table B. Type 1 diabetes: summary o
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T2DM: Description and Risk of Bias
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Figure D. Plot of network meta-anal
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The positive findings for behaviora
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elated to the Human Development Ind
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Table D. Potential research needs b
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References 1. Renders CM, Valk GD,
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37. Chodosh J, Morton SC, Mojica W,
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Introduction Background The high bu
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Factors other than blood glucose co
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may include interventions related t
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programs. The overarching boxes (co
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Figure 2. Analytic framework for be
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American Diabetes Association, Amer
Page 57 and 58: Table 1. Inclusion criteria for typ
Page 59 and 60: S1 in the Supplementary File). The
Page 61 and 62: clinically significant); we refer t
Page 63 and 64: Synthesis for T1DM (KQs 1-4) KQ 1:
Page 65 and 66: conducted for HbA 1c and body mass
Page 67 and 68: Applicability We followed the Metho
Page 69 and 70: Type 1 Diabetes Mellitus This secti
Page 71 and 72: therapy, 90,99,108 motivational enh
Page 73 and 74: and a peer (with diabetes and train
Page 75 and 76: followup (low SOE for both); there
Page 77 and 78: Figure 6. Behavioral programs for t
Page 79 and 80: similar results were found for yout
Page 81 and 82: HbA 1c : Comparative Effectiveness
Page 83 and 84: Two trials reported on adherence to
Page 85 and 86: Table 4. Other clinical and behavio
Page 87 and 88: Figure 14. Behavioral programs for
Page 89 and 90: Health-Related Quality of Life: Beh
Page 91 and 92: estimated effects were imprecise an
Page 93 and 94: Table 8. Type 1 diabetes: summary o
Page 95 and 96: Summary of Key Findings and Strengt
Page 97 and 98: studies 82,94,95,105,109,112 were n
Page 99 and 100: studied a DSME program in patients
Page 101 and 102: I 2 =74%), 135,137,139,141,142,145,
Page 103 and 104: Aerobic Fitness Test which estimate
Page 105 and 106: Key Points: Body Mass Index • Lif
Page 107: Table 12. Network meta-analysis for
Page 111 and 112: Table 13. Network meta-analysis for
Page 113 and 114: Figure 20. Plot of network meta-ana
Page 115 and 116: active comparator (20 trials, 7,709
Page 117 and 118: Discussion Key Findings and Discuss
Page 119 and 120: to be tempered by the findings of n
Page 121 and 122: compared with usual care. There was
Page 123 and 124: Our finding that single-topic, non-
Page 125 and 126: In their systematic review and meta
Page 127 and 128: For studies targeting adults, the m
Page 129 and 130: environmental contextual factors—
Page 131 and 132: assessors was also rarely reported,
Page 133 and 134: Tailoring programs to ethnic minori
Page 135 and 136: 17. Centers for Disease Control and
Page 137 and 138: 53. Medical Advisory Secretariat. B
Page 139 and 140: 88. Ellis DA, Templin T, Naar-King
Page 141 and 142: 122. Nansel TR, Iannotti RJ, Simons
Page 143 and 144: 158. Cooper H, Booth K, Gill G. A t
Page 145 and 146: 191. Koo BK, Han KA, Ahn HJ, et al.
Page 147 and 148: 224. Sevick MA, Korytkowski M, Ston
Page 149 and 150: 260. Yuan C, Lai CW, Chan LW, et al
Page 151 and 152: 295. Ayling K, Brierley S, Johnson
Page 153 and 154: Appendix A. Operational Definitions
Page 155 and 156: the structured diet or physical act
Page 157 and 158: Appendix B. Literature Search Strat
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1. MeSH descriptor: [Diabetes Melli
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35. “blood glucose” N2 monitor*
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35. (behavio?r adj2 therap*).mp. 36
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52. exp animals/ not humans.sh. 53.
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57. "Follow-Up Studies"[Mesh] 58. "
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URL provided by Michelle Crain, AAD
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WHO ICTRP Trial Registry: WHO ICTRP
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Appendix D. Studies Excluded After
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Health. 2006;6:134. PMID: 16709243.
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November/December;24(9):450-6. PMID
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89. Dinneen SF, O'hara MC, Byrne M,
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119. Fitzpatrick SL, Jeffery R, Joh
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Aug;19(8):835-42. PMID: 8842601. Ex
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adherence and metabolic control. Di
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May;36(5):1297-303. PMID: 23223405.
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244. Korytkowski MT, Koerbel GL, Ko
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275. Maljanian R, Grey N, Staff I,
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306. Naccashian Z. The impact of di
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led structured program on blood glu
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Engineering. 2014;75(1-B E). PMID:
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395. Skoro-Kondza L, Tai SS, Gadelr
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426. Torbjornsen A, Jenum AK, Smast
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Americans with type 2 diabetes. J A
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patients. Diabetes Res Clin Pract.
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Table E1. Risk of bias for studies
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Weinger, 2011 L M NA M NA L NA L L
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Cramer, 2007 M M H M H L H H L M H
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Ridgeway, 1999 M M H M H L H H M L
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Appendix F. Description of Studies
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Author, Year & Country Comparison &
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Table F3. Description of studies an
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Appendix H. Strength of Evidence Ta
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Outcome # Trials (# Subjects); Tool
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Table H3. Behavioral programs compa
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16. Mayer-Davis EJ, Seid M, Crandel
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Table I1. Effectiveness of behavior
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Category Health Outcomes Outcomes A
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Table I2. Effectiveness of behavior
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Category Outcomes Timepoint Health
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Outcome Change in Body Composition
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Outcome Change in Physical Activity
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References for Appendix I 1. Adachi
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32. Rock CL, Flatt SW, Pakiz B, et
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follow-up study. Diabetes Res Clin
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98. Johnson ST, Bell GJ, Mccargar L
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Appendix J. Network Meta-Analysis R
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5 11-26h In person Group only NA -0
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9 11-26h In person Group only NA -0
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Behavioral Programs for Diabetes Mellitus

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