Behavioral Programs for Diabetes Mellitus

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Table J1. Network meta-analysis results <strong>for</strong> HbA 1c <strong>for</strong> suboptimal glycemic control subgroup (HbA 1c ≥7%) Arm Description Rank Order of Effect & Studies (only those removed from original analysis) Intensity Method of Communication Delivery Method Delivery Personnel MD, 95% Credibility Interval Probability of Being Best Usual care NA 1-6 NA NA NA NA 0 [NA, NA] 0.0% Active comparator 28 7 NA NA NA NA -0.10 [-0.34, 0.15] 0.0% (non-DSME) Active comparator 24 8, 9 NA NA NA NA -0.14 [-0.55, 0.26] 0.0% (other) DSME 22 ≤10h In person Individual & mixed HCP -0.17 [-0.40, 0.07] 0.0% 20 ≤10h In person Group only HCP -0.20 [-0.47, 0.07] 0.0% 29 ≤10h In person Group only Non-HCP -0.03 [-0.96, 0.90] 0.4% 26 ≤10h Some technology Individual & mixed HCP -0.11 [-0.41, 0.18] 0.0% 21 1 ≤10h Some technology Individual & mixed Non-HCP -0.18 [-0.48, 0.11] 0.0% 17 11-26h In person Individual & mixed HCP -0.26 [-0.72, 0.20] 0.0% 18 3, 6 11-26h In person Group only HCP -0.26 [-0.48, -0.04] 0.0% 15 2, 4 11-26h In person Group only Non-HCP -0.34 [-0.78, 0.10] 0.0% 25 11-26h Some technology Individual & mixed HCP -0.12 [-0.47, 0.22] 0.0% 4 11-26h Some technology Individual & mixed Non-HCP -0.78 [-1.37, -0.18] 5.3% 27 11-26h Some technology Group only HCP -0.11 [-1.16, 0.93] 1.3% 7 ≥27h In person Individual & mixed HCP -0.73 [-1.61, 0.14] 10.1% 31 7 ≥27h In person Group only HCP 0.09 [-0.49, 0.68] 0.0% 9 ≥27h Some technology Individual & mixed HCP -0.70 [-1.60, 0.21] 9.3% DSME + Support 8 ≤10h In person Individual & mixed NA -0.70 [-1.52, 0.12] 7.7% 34 ≤10h In person Group only NA 2.83 [1.48, 4.20] 0.0% 16 ≤10h Some technology Individual & mixed NA -0.30 [-0.74, 0.13] 0.0% 10 11-26h In person Individual & mixed NA -0.64 [-1.70, 0.43] 10.5% 6 11-26h In person Group only NA -0.73 [-1.38, -0.10] 4.0% 13 11-26h Some technology Individual & mixed NA -0.36 [-0.86, 0.12] 0.0% 11 ≥27h In person Individual & mixed NA -0.55 [-1.08, -0.02] 0.6% 3 ≥27h In person Group only NA -0.88 [-1.66, -0.10] 14.4% Lifestyle 33 5 ≤10h In person Individual & mixed NA 0.50 [-0.35, 1.34] 0.0% 23 9 ≤10h In person Group only NA -0.15 [-1.16, 0.88] 1.4% 35 ≤10h Some technology Individual & mixed NA 0.40 [-0.83, 1.62] 0.4% 12 11-26h In person Individual & mixed NA -0.41 [-0.82, 0.01] 0.0% J-2
5 11-26h In person Group only NA -0.76 [-1.19, -0.33] 1.8% 1 11-26h Some technology Individual & mixed NA -1.01 [-1.61, -0.40] 19.4% 19 11-26h Some technology Group only NA -0.20 [-0.99, 0.59] 0.4% 2 8 ≥27h In person Individual & mixed NA -0.98 [-1.47, -0.50] 12.9% 30 ≥27h In person Group only NA 0.02 [-0.51, 0.57] 0.0% 25 ≥27h Some technology Individual & mixed NA -0.34 [-0.80, 0.11] 1.3% DSME = diabetes self-management education; h = hour(s); HCP = health care professional; MD = mean difference; NA = not applicable J-3
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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
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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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Page 255 and 256: Author, Year & Country Comparison &
Page 277 and 278: Appendix H. Strength of Evidence Ta
Page 279 and 280: Outcome # Trials (# Subjects); Tool
Page 281 and 282: Table H3. Behavioral programs compa
Page 283 and 284: 16. Mayer-Davis EJ, Seid M, Crandel
Page 285 and 286: Table I1. Effectiveness of behavior
Page 287 and 288: Category Health Outcomes Outcomes A
Page 289 and 290: Table I2. Effectiveness of behavior
Page 291 and 292: Category Outcomes Timepoint Health
Page 293 and 294: Outcome Change in Body Composition
Page 295 and 296: Outcome Change in Physical Activity
Page 297 and 298: References for Appendix I 1. Adachi
Page 299 and 300: 32. Rock CL, Flatt SW, Pakiz B, et
Page 301 and 302: follow-up study. Diabetes Res Clin
Page 303 and 304: 98. Johnson ST, Bell GJ, Mccargar L
Page 305: Appendix J. Network Meta-Analysis R
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Behavioral Programs for Diabetes Mellitus

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