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Psychological interventions to improve glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis

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Psychological interventions to improve glycemic control in adults with type 2 diabetes : A systematic review and meta-analysis. / Winkley, Kirsty; Upsher, Rebecca; Stahl, Daniel; Pollard, Daniel; Brennan, Alan; Heller, Simon R.; Ismail, Khalida.

In: BMJ Open Diabetes Research and Care, Vol. 8, No. 1, e001150, 08.04.2020.

Research output: Contribution to journalReview article

Harvard

Winkley, K, Upsher, R, Stahl, D, Pollard, D, Brennan, A, Heller, SR & Ismail, K 2020, 'Psychological interventions to improve glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis', BMJ Open Diabetes Research and Care, vol. 8, no. 1, e001150. https://doi.org/10.1136/bmjdrc-2019-001150

APA

Winkley, K., Upsher, R., Stahl, D., Pollard, D., Brennan, A., Heller, S. R., & Ismail, K. (2020). Psychological interventions to improve glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis. BMJ Open Diabetes Research and Care, 8(1), [e001150]. https://doi.org/10.1136/bmjdrc-2019-001150

Vancouver

Winkley K, Upsher R, Stahl D, Pollard D, Brennan A, Heller SR et al. Psychological interventions to improve glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis. BMJ Open Diabetes Research and Care. 2020 Apr 8;8(1). e001150. https://doi.org/10.1136/bmjdrc-2019-001150

Author

Winkley, Kirsty ; Upsher, Rebecca ; Stahl, Daniel ; Pollard, Daniel ; Brennan, Alan ; Heller, Simon R. ; Ismail, Khalida. / Psychological interventions to improve glycemic control in adults with type 2 diabetes : A systematic review and meta-analysis. In: BMJ Open Diabetes Research and Care. 2020 ; Vol. 8, No. 1.

Bibtex Download

@article{185dd40b49b94c5cabc457ff80650118,
title = "Psychological interventions to improve glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis",
abstract = "The quality of evidence that psychological interventions are effective in improving glycemic control in adults with type 2 diabetes (T2D) is weak. We conducted a systematic review and meta-analysis of psychological interventions in T2D to assess whether their effectiveness in improving glycemic levels has improved over the past 30 years. We applied the protocol of a systematic review and aggregate meta-analysis conducted to January 2003. We added network meta-analysis (NMA) to compare intervention and control group type against usual care. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, EMBASE, Cochrane Controlled Trials Database, Web of Science, and Dissertation Abstracts International were searched from January 2003 to July 2018. Only randomized controlled trials (RCT) of psychological interventions for adults with T2D reported in any language were included. The primary outcome was change in glycemic control (glycated hemoglobin (HbA1c) in mmol/mol). Data were extracted from study reports and authors were contacted for missing data. 94 RCTs were eligible for inclusion in the systematic review since the last review. In 70 RCTs (n=14 796 participants) the pooled mean difference in HbA1c in those randomized to psychological intervention compared with control group was-0.19 (95{\%} CI-0.25 to-0.12), equivalent to a reduction in HbA1c of 3.7 mmol/mol, with moderate heterogeneity across studies (I 2 =64.7{\%}, p<0.001). NMA suggested the probability of intervention effectiveness is highest for self-help materials, cognitive-behavioral therapy, and counseling, compared with usual care. Limitations of this study include that there is a possibility that some studies may have been missed if diabetes did not appear in the title or abstract. The effectiveness of psychological interventions for adults with T2D have minimal clinical benefit in improving glycemic control. PROSPERO registration number CRD42016033619.",
keywords = "meta-analysis, psychology, randomized controlled trial, type 2 diabetes",
author = "Kirsty Winkley and Rebecca Upsher and Daniel Stahl and Daniel Pollard and Alan Brennan and Heller, {Simon R.} and Khalida Ismail",
year = "2020",
month = "4",
day = "8",
doi = "10.1136/bmjdrc-2019-001150",
language = "English",
volume = "8",
journal = "BMJ Open Diabetes Research & Care",
issn = "2052-4897",
publisher = "BMJ Journals",
number = "1",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Psychological interventions to improve glycemic control in adults with type 2 diabetes

T2 - A systematic review and meta-analysis

AU - Winkley, Kirsty

AU - Upsher, Rebecca

AU - Stahl, Daniel

AU - Pollard, Daniel

AU - Brennan, Alan

AU - Heller, Simon R.

AU - Ismail, Khalida

PY - 2020/4/8

Y1 - 2020/4/8

N2 - The quality of evidence that psychological interventions are effective in improving glycemic control in adults with type 2 diabetes (T2D) is weak. We conducted a systematic review and meta-analysis of psychological interventions in T2D to assess whether their effectiveness in improving glycemic levels has improved over the past 30 years. We applied the protocol of a systematic review and aggregate meta-analysis conducted to January 2003. We added network meta-analysis (NMA) to compare intervention and control group type against usual care. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, EMBASE, Cochrane Controlled Trials Database, Web of Science, and Dissertation Abstracts International were searched from January 2003 to July 2018. Only randomized controlled trials (RCT) of psychological interventions for adults with T2D reported in any language were included. The primary outcome was change in glycemic control (glycated hemoglobin (HbA1c) in mmol/mol). Data were extracted from study reports and authors were contacted for missing data. 94 RCTs were eligible for inclusion in the systematic review since the last review. In 70 RCTs (n=14 796 participants) the pooled mean difference in HbA1c in those randomized to psychological intervention compared with control group was-0.19 (95% CI-0.25 to-0.12), equivalent to a reduction in HbA1c of 3.7 mmol/mol, with moderate heterogeneity across studies (I 2 =64.7%, p<0.001). NMA suggested the probability of intervention effectiveness is highest for self-help materials, cognitive-behavioral therapy, and counseling, compared with usual care. Limitations of this study include that there is a possibility that some studies may have been missed if diabetes did not appear in the title or abstract. The effectiveness of psychological interventions for adults with T2D have minimal clinical benefit in improving glycemic control. PROSPERO registration number CRD42016033619.

AB - The quality of evidence that psychological interventions are effective in improving glycemic control in adults with type 2 diabetes (T2D) is weak. We conducted a systematic review and meta-analysis of psychological interventions in T2D to assess whether their effectiveness in improving glycemic levels has improved over the past 30 years. We applied the protocol of a systematic review and aggregate meta-analysis conducted to January 2003. We added network meta-analysis (NMA) to compare intervention and control group type against usual care. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, EMBASE, Cochrane Controlled Trials Database, Web of Science, and Dissertation Abstracts International were searched from January 2003 to July 2018. Only randomized controlled trials (RCT) of psychological interventions for adults with T2D reported in any language were included. The primary outcome was change in glycemic control (glycated hemoglobin (HbA1c) in mmol/mol). Data were extracted from study reports and authors were contacted for missing data. 94 RCTs were eligible for inclusion in the systematic review since the last review. In 70 RCTs (n=14 796 participants) the pooled mean difference in HbA1c in those randomized to psychological intervention compared with control group was-0.19 (95% CI-0.25 to-0.12), equivalent to a reduction in HbA1c of 3.7 mmol/mol, with moderate heterogeneity across studies (I 2 =64.7%, p<0.001). NMA suggested the probability of intervention effectiveness is highest for self-help materials, cognitive-behavioral therapy, and counseling, compared with usual care. Limitations of this study include that there is a possibility that some studies may have been missed if diabetes did not appear in the title or abstract. The effectiveness of psychological interventions for adults with T2D have minimal clinical benefit in improving glycemic control. PROSPERO registration number CRD42016033619.

KW - meta-analysis

KW - psychology

KW - randomized controlled trial

KW - type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85083219938&partnerID=8YFLogxK

U2 - 10.1136/bmjdrc-2019-001150

DO - 10.1136/bmjdrc-2019-001150

M3 - Review article

C2 - 32273289

AN - SCOPUS:85083219938

VL - 8

JO - BMJ Open Diabetes Research & Care

JF - BMJ Open Diabetes Research & Care

SN - 2052-4897

IS - 1

M1 - e001150

ER -

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