Educational weight loss interventions in obese and overweight adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.
Diabet Med
; 37(4): 623-635, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-31785118
AIM: The worldwide prevalence of type 2 diabetes mellitus is increasing, with most individuals with the disease being overweight or obese. Weight loss can reduce disease-related morbidity and mortality and weight losses of 10-15 kg have been shown to reverse type 2 diabetes. This review aimed to determine the effectiveness of community-based educational interventions for weight loss in type 2 diabetes. METHODS: This is a systematic review and meta-analysis of randomized controlled trials (RCT) in obese or overweight adults, aged 18-75 years, with a diagnosis of type 2 diabetes. Primary outcomes were weight and/or BMI. CINAHL, MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to June 2019. Trials were classified into specified a priori comparisons according to intervention type. A pooled standardized mean difference (SMD) (from baseline to follow-up) and 95% confidence intervals (95% CI) between trial groups (difference-in-difference) were estimated through random-effects meta-analyses using the inverse variance method. Heterogeneity was quantified using I2 and publication bias was explored visually using funnel plots. RESULTS: Some 7383 records were screened; 228 full-text articles were assessed and 49 RCTs (n = 12 461 participants) were included in this review, with 44 being suitable for inclusion into the meta-analysis. Pooled estimates of education combined with low-calorie, low-carbohydrate meal replacements (SMD = -2.48, 95% CI -3.59, -1.49, I2 = 98%) or diets (SMD = -1.25, 95% CI -2.11, -0.39, I2 = 95%) or low-fat meal replacements (SMD = -1.15, 95%CI -2.05, -1.09, I2 = 85%) appeared most effective. CONCLUSION: Low-calorie, low-carbohydrate meal replacements or diets combined with education appear the most promising interventions to achieve the largest weight and BMI reductions in people with type 2 diabetes.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Educación del Paciente como Asunto
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Diabetes Mellitus Tipo 2
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Sobrepeso
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Programas de Reducción de Peso
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Obesidad
Tipo de estudio:
Clinical_trials
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Risk_factors_studies
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Systematic_reviews
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Diabet Med
Asunto de la revista:
ENDOCRINOLOGIA
Año:
2020
Tipo del documento:
Article
Pais de publicación:
Reino Unido