Behavioral Programs for Diabetes Mellitus

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Figure 19. Plot of network meta-analysis results for effect moderation on HbA 1c in T2DM This plot depicts the results from our network meta-analysis for the outcome of HbA 1c (negative values favorable) when comparing groups (“nodes”) of interventions, with each group differing by at least one level in the categories of program component, intensity, mode of communication, delivery method, and (for DSME programs only) delivery personnel (see Table 3 for categorization schema and the figure legend for a description of each node). The dots and lines represent the mean difference (MD) and 95 percent credibility intervals for the represented programs relative to usual care; the figure indicates which MDs meet or exceed our predetermined threshold for clinical importance (reduction in HbA 1c of ≥0.4%). The estimated MDs and 95% credibility intervals are included in Table 12. 66
Table 13. Network meta-analysis for effect moderation on body mass index results for T2DM: description of nodes and results Rank Order of Effect, Method of MD (kg∙m -2 ), 95% Probability of Arm Description Studies & Sample Size Intensity Delivery Method Communication Credibility Interval Being Best of Study Arms Usual care (reference category) NA 135- 137,139,141,143,145,151,153,155,157, 162,163,171,173,175,179,183,184,189, 190,193,206,208,210,211,214,215,224, 226,233,238- 242,246,249,251,255,257,259-261 N = 3,341 Active comparator 23 146,154,169,175,184,192 (non-DSME) N = 684 Active comparator 15 156,174,186,202 (other) N = 99 DSME 13 135,153,154,212,238,257 N = 629 7 146,172,173,199,211,212 N = 771 20 171,175,179,183,226,241,259 N = 470 22 192,206 N = 194 12 136,141,155,163,170,192,193,199, 224,246,260,264 N = 939 9 162,233,242 N = 379 24 264 N = 15 16 139,215 N = 161 6 202 N = 3 NA NA NA 0 [NA, NA] 0.0% NA NA NA 0.13 [-0.64, 0.88] 0.0% NA NA NA -0.21 [-1.69, 1.26] 0.1% ≤10h In person Individual & mixed -0.32 [-1.03, 0.33] 0.0% ≤10h In person Group only -0.61 [-1.37, 0.17] 0.1% ≤10h Some technology Individual & mixed -0.14 [-0.81, 0.53] 0.0% 11-26h In person Individual & 0.10 [-1.27, 1.47] 0.1% mixed 11-26h In person Group only -0.33 [-0.80, 0.12] 0.0% 11-26h Some technology Individual & -0.55 [-1.29, 0.25] 0.1% mixed 11-26h Some technology Group only 0.38 [-2.97, 3.72] 5.2% ≥27h In person Group only -0.21 [-2.03, 1.60] 1.8% ≥27h In person Individual & mixed -0.71 [-2.62, 1.19] 5.0% 67
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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
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Table 1. Inclusion criteria for typ
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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
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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
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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 and 108: Table 12. Network meta-analysis for
Page 109: Table 12. 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
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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
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Page 131 and 132: assessors was also rarely reported,
Page 133 and 134: Tailoring programs to ethnic minori
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Page 145 and 146: 191. Koo BK, Han KA, Ahn HJ, et al.
Page 147 and 148: 224. Sevick MA, Korytkowski M, Ston
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Page 153 and 154: Appendix A. Operational Definitions
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Page 157 and 158: Appendix B. Literature Search Strat
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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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