Behavioral Programs for Diabetes Mellitus

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Table F2. Description of studies and interventions <strong>for</strong> T1DM in adults Author, Year & Country Comparison & Sample Size Age, Males, Ethnic Minorities, HbA1c Intervention Category & Description Total Duration, # Contacts, Contact Time Method of Communication (In-person, Mixed, Technology) Method of Delivery (Individual, Group, Mixed) Delivery Personnel (Non-HCP, Single HCP, Multidisciplinary) Degree of Tailoring Community Engagement Amsberg, 2009 Sweden Forlani, 2006 Italy Observ. Hermanns, 2013 Germany Ismail, 2008 United Kingdom I= 46 UC= 48 I= 54 UC= 36 I= 81 AC= 79 I= 106 UC= 121 NR on Active control I= 41.1±11.7y, 56%, NR, 8.5±0.9% C= 41.4±12.9y, 42%, NR, 8.5±0.8% I= 43 (18–65)y (Median, Range), 33%, NR, 8.2±1.6% UC= 41 (26– 65)y (Median, Range), 66%, NR, 8.1±1.2% I= 45.9±13.8y, 61.7%, NR, 8.3±1.1% AC= 45.1±13.4y, 50.6%, NR, 8.0±0.9% I= 37.2±9.9y, 37.7%, 21%, 9.6±1.3% UC=36.4±11.3y, 45,4%, 14%, 9.7±1.2% DSME + Support; CBT-based with CGMS (“Power to Choose Your Direction”) DSME; empowerment group teaching & situation simulation I= DSME; PRIMAS empowerment approach AC= Non-DSME education; standard in Germany DSME; Motivational Enhancement Therapy & CBT 11, 12 + 5 telephone contacts, 18.25h + telephone contact time Mixed Mixed Multidisciplinary (RN, Pysch) (Maintenance phase = 9m) 4m, 8, 16h In-person Group HCP (Physician or RD) I= 1.5m, 12, 18h AC= 1.5m, 12, 18 I= In-person AC= Inperson I= Group AC= Group I= HCP (CDE) AC= HCP (CDE) Moderateto-High – Content & Delivery Moderateto-High - Content I= Moderateto-High – Content AC= None 6m, 12, 10h In-person Individual HCP (DSN) Moderateto-High - Content None/NR None/NR I= None/NR AC= None/NR None/NR F-8
Author, Year & Country Comparison & Sample Size Age, Males, Ethnic Minorities, HbA1c Intervention Category & Description Total Duration, # Contacts, Contact Time Method of Communication (In-person, Mixed, Technology) Method of Delivery (Individual, Group, Mixed) Delivery Personnel (Non-HCP, Single HCP, Multidisciplinary) Degree of Tailoring Community Engagement Karlsen, 2004 Norway Mannucci, 2005 Italy (Non-RCT) Perry, 1997 New Zealand Weinger, 2011 U.S. (MA) I= 47 UC= 45 I= 96 UC= 37 I= 31 UC= 30 I=74 AC 1= 75 AC 2= 73 I= 49.2±14.7y, 52%, NR, 7.9±1.2% UC= 48.6±10.3y, 53%, NR, 8.4±1.2% I= 30.7±8.4y, 44%, NR, 7.7±1.4% UC= 30.3±12.2y, 43%, NR, 7.9±1.6% I= 41.5±11.6y, 66.7%, NR, 8.9±2.6% UC= 42.8±12.6y, 48.4%, NR, 8.7±2.0% I= 51.8 (23.7- 74.2)y 54%, 12% 9.0 (7.6-12.6)%, 50% AC 1= 54.7 (25.0-75.1)y 52%, 11% 8.8 (7.6-13.6)%, 50% DSME; CBTbased program DSME; Interactive Educational and Support Group (IESG), physicianled long-term open group education program Lifestyle; multiple topics with individualized diet and physical activity prescriptions I= DSME; CBTbased group education program AC 1= Non-DSME (didactic group sessions) AC 2= Non-DSME (individual RN & 6m, 6, 9h In-person Group Non-HCP (peers) & HCP (DSN) 12m, 26, 52h In-person Group HCP (Physicians) 6m, 6 + additional sessions or telephone calls, NR I= 1.5m, 5, 10h AC 1= 1.5, 5, 10h AC 2= 6m, NR, NR In-person Individual Multidisciplinary (RD & others in research team) I= In-person AC 1= Inperson AC 2= Inperson I= Group AC 1= Group AC 2= Individual I= Multidisciplinary (RN, RD) AC 1= RN AC 2= Multidisciplinary (RN, RD) Moderateto-High – Content & Delivery Moderateto-High – Content & Delivery Moderateto-High – Content & Delivery I= Moderateto-High – Content AC 1= Minimal – Content AC 2= Minimal – Yes None/NR None/NR I= None/NR AC 1= None/NR AC 2= None/NR F-9
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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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S1 in the Supplementary File). The
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clinically significant); we refer t
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Synthesis for T1DM (KQs 1-4) KQ 1:
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conducted for HbA 1c and body mass
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Applicability We followed the Metho
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Type 1 Diabetes Mellitus This secti
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therapy, 90,99,108 motivational enh
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and a peer (with diabetes and train
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followup (low SOE for both); there
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Figure 6. Behavioral programs for t
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similar results were found for yout
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HbA 1c : Comparative Effectiveness
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Two trials reported on adherence to
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Table 4. Other clinical and behavio
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Figure 14. Behavioral programs for
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Health-Related Quality of Life: Beh
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estimated effects were imprecise an
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Table 8. Type 1 diabetes: summary o
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Summary of Key Findings and Strengt
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studies 82,94,95,105,109,112 were n
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studied a DSME program in patients
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I 2 =74%), 135,137,139,141,142,145,
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Aerobic Fitness Test which estimate
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Key Points: Body Mass Index • Lif
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Table 12. Network meta-analysis for
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Figure 20. Plot of network meta-ana
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active comparator (20 trials, 7,709
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Discussion Key Findings and Discuss
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to be tempered by the findings of n
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compared with usual care. There was
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Our finding that single-topic, non-
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In their systematic review and meta
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For studies targeting adults, the m
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environmental contextual factors—
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assessors was also rarely reported,
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Tailoring programs to ethnic minori
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17. Centers for Disease Control and
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53. Medical Advisory Secretariat. B
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88. Ellis DA, Templin T, Naar-King
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122. Nansel TR, Iannotti RJ, Simons
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158. Cooper H, Booth K, Gill G. A t
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191. Koo BK, Han KA, Ahn HJ, et al.
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224. Sevick MA, Korytkowski M, Ston
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260. Yuan C, Lai CW, Chan LW, et al
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295. Ayling K, Brierley S, Johnson
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Appendix A. Operational Definitions
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the structured diet or physical act
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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
Page 171 and 172: WHO ICTRP Trial Registry: WHO ICTRP
Page 173 and 174: Appendix D. Studies Excluded After
Page 175 and 176: Health. 2006;6:134. PMID: 16709243.
Page 177 and 178: November/December;24(9):450-6. PMID
Page 179 and 180: 89. Dinneen SF, O'hara MC, Byrne M,
Page 181 and 182: 119. Fitzpatrick SL, Jeffery R, Joh
Page 183 and 184: Aug;19(8):835-42. PMID: 8842601. Ex
Page 185 and 186: adherence and metabolic control. Di
Page 187 and 188: May;36(5):1297-303. PMID: 23223405.
Page 189 and 190: 244. Korytkowski MT, Koerbel GL, Ko
Page 191 and 192: 275. Maljanian R, Grey N, Staff I,
Page 193 and 194: 306. Naccashian Z. The impact of di
Page 195 and 196: led structured program on blood glu
Page 197 and 198: Engineering. 2014;75(1-B E). PMID:
Page 199 and 200: 395. Skoro-Kondza L, Tai SS, Gadelr
Page 201 and 202: 426. Torbjornsen A, Jenum AK, Smast
Page 203 and 204: Americans with type 2 diabetes. J A
Page 205 and 206: patients. Diabetes Res Clin Pract.
Page 207 and 208: Table E1. Risk of bias for studies
Page 209 and 210: Weinger, 2011 L M NA M NA L NA L L
Page 211 and 212: Cramer, 2007 M M H M H L H H L M H
Page 213 and 214: Ridgeway, 1999 M M H M H L H H M L
Page 215 and 216: Appendix F. Description of Studies
Page 217 and 218: Author, Year & Country Comparison &
Page 221: Author, Year & Country Comparison &
Page 225 and 226: Table F3. Description of studies an
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Author, Year & Country Comparison &
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Author, Year & Country Comparison &
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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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