Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes.
This meta-analysis was conducted to assess the effect of educational and behavioral interventions on body weight and glycemic control in type 2 diabetes.



Studies selected for analysis were published randomized controlled trials that evaluated educational and behavioral interventions (no drug interventions) in type 2 diabetes (sample size > or = 10). These criteria were applied to searches of electronic databases and relevant bibliographies. Data were independently abstracted by 2 reviewers and adjudicated by consensus.



Of the 63 articles that met the inclusion criteria, 18 provided enough information for pooled estimates of glycohemoglobin (total Ghb, HbA1, or HbA1C). These 18 studies yielded 2720 participants (sample sizes of 18 to 749). Interventions ranged from 1 to 19 months; follow-up ranged from 1 to 26 months. Glycohemoglobin was reduced by a mean of 0.43%. When results were stratified by quality score, glycohemoglobin was -0.50% and -0.38% for studies with high and low quality scores, respectively. When weighting studies by sample size, fasting blood glucose was reduced by 24 mg/dL and weight by 3 lbs.



Previous educational and behavioral interventions in type 2 diabetes have produced modest improvements in glycemic control. Future research should refine such interventions and improve methodology.
Gary
Tiffany L
TL
The Departments of Epidemiolo­gy, The Johns Hop­kins University, Baltimore, Maryland (Drs Gary, Guallar, and Brancati, and Ms Genkinger)
Genkinger
Jeanine M
JM
The Departments of Epidemiolo­gy, The Johns Hop­kins University, Baltimore, Maryland (Drs Gary, Guallar, and Brancati, and Ms Genkinger)
Guallar
Eliseo
E
The Departments of Epidemiolo­gy, The Johns Hop­kins University, Baltimore, Maryland (Drs Gary, Guallar, and Brancati, and Ms Genkinger)
Peyrot
Mark
M
Medicine, The Johns Hop­kins University, Baltimore, Maryland (Drs Peyrot and Brancati)|The Department of Sociology (Dr Peyrot), Loyola College, Baltimore, Maryland
Brancati
Frederick L
FL
Medicine, The Johns Hop­kins University, Baltimore, Maryland (Drs Peyrot and Brancati)
D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000517:prevention & control*; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012648:Self Care / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome
D001786:Blood Glucose; D006442:Glycated Hemoglobin