Category <strong>Behavioral</strong> Outcomes Outcomes (mmol/l) Systolic Blood Pressure (mmHg) Diastolic Blood Pressure (mmHg) Depression Symptoms Anxiety Symptoms Change in Physical Activity - Duration/ Intensity (Subjective [days/week]) Change in Physical Activity - Duration/ Intensity (Objective) Change in Physical Activity – Fitness Change in Physical # Comparisons (# Subjects) 14, 18, 21, 22, 25, 29-33, 41, 42, 48, 49, 55, 60, 62, 63 1-4, 6, 7, 36 (4,776) 9, 10, 12-14, 18, 21, 22, 25, 26, 28-30, 32, 33, 39, 41, 42, 47, 49, 51, 53, 58, 60, 62, 63, 80, 84 1-4, 6, 7, 33 (4,583) 9, 10, 12, 13, 18, 21, 22, 25, 26, 28-30, 32, 39, 41, 42, 47, 49, 53, 58, 60, 62, 63, 80, 84 5, 7, 17, 13 (1,751) 21, 32-34, 38, 49, 53, 61, 62 Timepoint EOI 6m 12m Study Effect 95% CI - 0.24 to -0.1; I 2 =36% MD, -0.78; 95% CI -1.3 to -0.26; I 2 =23% MD, -0.94; 95% CI - 1.32 to - 0.56; I 2 =32% SMD, -0.16; 95% CI - 0.32 to 0; I 2 =45% # Comparisons (# Subjects) 68 14, 33, 51, 10 (1,613) 53, 62, 68, 78, 84 33, 53, 62, 7 (1,424) 68, 78, 84 33, 53, 62, 5 (1,189) 72, 74 Study Effect 95% CI -0.37 to 0.01; I 2 =6% MD, -1.08; 95% CI -2.9 to 0.74; I 2 =0% MD, -1.26; 95% CI -1.97 to -0.55; I 2 =0% SMD, -0.09; 95% CI -0.57 to 0.39; I 2 =80% # Comparisons (# Subjects) Study Effect CI -0.45 to 0.05; I 2 =NA 1 (291) 68 MD, -2.80; 95% CI -7.69 to 2.09; I 2 =NA 1 (291) 68 MD, -2.20; 95% CI -4.73 to 0.33; I 2 =NA NA NA NA NA NA NA 19, 37, 43, 7 (1,176) 49, 50, 54, 83 MD, 0.56; 95% CI -0.1 to 1.22; I 2 =79% SMD, 0.49; 5 (373) 20, 23, 39, 48 95% CI - 0.24 to 1.22; I 2 =74% SMD, 0.67; 2 (329) 15, 60 95% CI - 7.37 to 8.71; I 2 =90% 2 (270) 68, 87 MD, 1.73; 95% CI -8.82 to 12.28; I 2 =91% NA NA MD, 0.90; 95% 2 (382) 68, 83 CI 0.9 to 0.9; I 2 =0% NA NA NA NA 1 (134) 67 SMD, 0.03; 95% CI -0.30 to 0.37; I 2 =NA 1 (134) 67 SMD, 0.11; 95% CI -0.23 to 0.44; I 2 =NA NA NA NA NA NA NA I-3
Category Health Outcomes Outcomes Activity – Strength Change in Dietary Intake – Energy Intake (kcal/day) Change in Dietary Intake – Saturated Fat Intake (% of daily kcal) Adherence to Medication (higher scores desirable) Quality of Life – SF-36 Physical (higher score desirable) Quality of Life – SF-36 Mental (higher score desirable) Quality of Life – Other (higher score desirable) <strong>Diabetes</strong>specific Quality of Life – <strong>Diabetes</strong> Distress (PAID) (lower scores # Comparisons (# Subjects) 1, 2, 10, 11 (1,164) 20, 23, 33, 34, 60, 84, 88 2, 10, 20, 10 (1,208) 33, 34, 49, 50, 60, 88 Timepoint EOI 6m 12m Study Effect MD, - 149.62; 95% CI -243.01 to -56.23; I 2 =68% MD, -0.24; 95% CI - 0.73 to 0.25; I 2 =44% 4 (742) 13, 15, 54, 83 SMD, -0.17; 95% CI -0.7 to 0.36; I 2 =75% MD, 0.45; 5 (787) 10, 32, 39, 49 95% CI - 0.05 to 0.95; I 2 =0% MD, 1.60; 5 (787) 10, 32, 39, 49 95% CI - 1.96 to 5.16; I 2 =86% SMD, 0.12; 4 (447) 27, 43, 53, 54 95% CI - 0.26 to 0.5; I 2 =40% 5, 7, 36, 42- 8 (1,384) 44, 47, 75 MD, -1.82; 95% CI - 3.43 to - 0.21; I 2 =0% # Comparisons (# Subjects) Study Effect MD, -64.05; 3 (469) 33, 68, 84 95% CI - 96.44 to - 31.66; I 2 =0% 2 (232) 33, 68 MD, -0.40; 95% CI -8.82 to 8.02; I 2 =23% 1 (54) 87 SMD, 0.42; 95% CI -0.12 to 0.96; I 2 =NA # Comparisons (# Subjects) Study Effect 1 (191) 68 MD, 114.00; 95% CI -308.19 to 536.19; I 2 =NA 1 (191) 68 MD, -1.10; 95% CI -2.22 to 0.02; I 2 =NA 1 (191) 83 SMD, -0.50; 95% CI -0.79 to -0.21; I 2 =NA NA NA NA NA NA NA NA NA 3 (789) 53, 73, 74 SMD, 0.08; 95% CI -0.11 to 0.27; I 2 =0% 4 (1,382) 67, 75, 78 MD, -1.89; 95% CI -4.37 to 0.59; I 2 =0% NA NA 3 (757) 67, 78 MD, -1.30; 95% CI -5.84 to 3.24; I 2 =0% I-4
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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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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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Table 12. Network meta-analysis for
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Table 13. 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
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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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Author, Year & Country Comparison &
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Author, Year & Country Comparison &
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Author, Year & Country Comparison &
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Table F3. Description of studies an
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Author, Year & Country Comparison &
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