Impact of lifestyle interventions on depressive symptoms in individuals at-risk of, or with, type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials.
Depression affects one in four individuals with type 2 diabetes mellitus (T2DM). The impact of T2DM lifestyle interventions on depression is unclear. The aim of this analysis was to examine the influence of lifestyle interventions on depressive symptoms scores in individuals at-risk of or with T2DM.



Major bibliographic databases were searched for studies published in English from 1990 to 2015. Meta-analysis was conducted by random-effects model. Nineteen studies were included in the meta-analyses. A significant reduction in depression scores was shown for lifestyle interventions in the pooled analysis (Standardized Mean Difference (SMD): -0.165; 95%CI: -0.265, -0.064; I(2):67.9%) and when limited to individuals with T2DM (SMD: -0.202; 95%CI: -0.288, -0.079; I(2):72.5%). In subgroup analyses the most effective intervention methods were face-to-face individual consultations (SMD: -0.241; 95%CI: -0.403, -0.078, I(2): 50.8%) with a duration of ≤6 months (SMD: -0.203; 95%CI: -0.381, -0.026, I(2):59.9%). Interventions were most effective when delivered four times a month (SMD: -0.247; 95%CI: -0.441, -0.053, I(2):76.3%).



Lifestyle interventions were effective in improving depression among people with T2DM.
School of Public Health, Department of Epidemiology, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, SP 01246-904, Brazil.
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Cezaretto
School of Public Health, Department of Epidemiology, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, SP 01246-904, Brazil.
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Ferreira
Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, 5-10 University Terrace, 8303 112 Street, Edmonton, Alberta T6G 2T4, Canada.
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Sharma
Health Research Methodology, Department of Clinical Epidemiology & Biostatistics, McMaster University, ON, Canada; Regional Knowledge Hub and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Sadeghirad
Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, 5-10 University Terrace, 8303 112 Street, Edmonton, Alberta T6G 2T4, Canada. Electronic address: fariba.kolahdooz@ualberta.ca.
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Kolahdooz
D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D055815:Young Adult
Depression; Diabetes; Lifestyle intervention