title: Efficacy of lifestyle interventions in patients with type 2 diabetes: A systematic review and meta-analysis.
abstract: BACKGROUND
  The current meta-analysis evaluated the outcomes of various lifestyle interventions, including diet modifications (DIET), physical activity (PA), and patient education (EDU) in reducing the risk of cardiovascular disease in patients with type 2 diabetes.
  
  
  METHODS
  Randomized clinical trials comparing lifestyle intervention with "usual care" (control) in type 2 diabetes patients were hand-searched from medical databases by two independent reviewers using the terms "diabetes, cardiovascular risk, lifestyle, health education, dietary, exercise/physical activities, and behavior intervention".
  
  
  RESULTS
  Of the 235 studies identified, 17 were chosen for the meta-analysis. The average age of patients ranged from 50-67.3 years. Results reveal no significant difference between the groups, with respect to BMI, while PA and DIET yielded a greater reduction in HbA1c. Significant reduction in both systolic and diastolic pressures in the DIET group, and diastolic pressure in the PA group, was observed. HDL-c in the DIET group was significantly higher than the control group, while no change in LDL-c levels, was seen in all three intervention subtypes. There was no difference between the EDU vs. the control group in terms of HbA1c, blood pressure or HDL-c and LDL-c.
  
  
  CONCLUSIONS
  DIET intervention showed an improvement in HbA1c, systolic/diastolic blood pressure and HDL-c, with an exception of LDL-c and BMI, suggesting that nutritional intervention had a significant impact on the quality of life by reducing the cardiovascular risk in type 2 diabetes patients.
authors.affiliation: Department of Nephrology, The First Hospital of Wuhan, China. Electronic address: 5051huangxiaoli@163.com.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Huang
authors.affiliation: Department of Nephrology, The First Hospital of Wuhan, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Pan
authors.affiliation: Department of Nephrology, The First Hospital of Wuhan, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Nephrology, The First Hospital of Wuhan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Nephrology, The First Hospital of Wuhan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Nephrology, The First Hospital of Wuhan, China.
authors.forename: Tao-Tao
authors.initials: TT
authors.lastname: Hu
mesh_terms: D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D004032:Diet; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D010353:Patient Education as Topic / Q000379:methods*; D017594:Publication Bias; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Cardiovascular; Diabetes; Intervention; Lifestyle; Meta-analysis