1. Lipid profile / HDL-Cholesterol (mmol) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
2.64 [-3.54, 8.82] |
Very low |
It may result in a large decrease in HDL levels (mmol/L) |
0 |
0 |
[, ] |
NA |
1.0 |
2.64 [-3.54, 8.82] |
Low |
2. Dietary habits / Consumption of fat |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.42 [-1.66, 2.51] |
Very low |
It may result in little to no difference in fat consumption |
0 |
0 |
[, ] |
N/A |
1.0 |
0.42 [-1.66, 2.51] |
Low |
3. Weight (management) / Weight (Kgs/lbs) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
5.2 [-0.24, 10.64] |
Very low |
It may result in little to no difference in weight (kgs) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
5.2 [-0.24, 10.64] |
Low |
4. Weight (management) / Waist size |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
4.53 [-5.63, 14.69] |
Low |
It may result in little to no difference in waist size (cm) |
0 |
0 |
[, ] |
NA |
2.0 |
4.53 [-5.63, 14.69] |
Low |
5. Quality of life / Psychological distress |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.22 [-1.21, 0.77] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
-0.22 [-1.21, 0.77] |
Low |
6. Self-monitoring / Glucose self-monitoring |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
2.53 [1.36, 3.69] |
Low |
It may result in a large increase in glucose self-monitoring |
1 |
60 |
2.53 [1.36, 3.69] |
Low |
0.0 |
NA [NA, NA] |
NA |
7. Self-management behaviours / Foot care |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
2.76 [2.02, 3.5] |
Low |
It may result in a large increase in foot care self-management |
1 |
60 |
2.76 [2.02, 3.5] |
Low |
0.0 |
NA [NA, NA] |
NA |
8. Blood-pressure / Diastolic pressure |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-1.77 [-4.88, 1.33] |
Low |
It may result in little to no difference in diastolic blood pressure (mmHg) |
1 |
109 |
-7.5 [-12.39, -2.61] |
Moderate |
2.0 |
2.1 [-1.92, 6.12] |
Low |
9. Blood-pressure / Systolic pressure |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.04 [-5.99, 5.91] |
Very low |
It may decrease systolic blood pressure levels (mmHg) but the evidence is very uncertain |
1 |
109 |
-5.6 [-15.24, 4.04] |
Low |
2.0 |
3.37 [-4.19, 10.93] |
Low |
10. Self-management behaviours |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.31 [-0.97, 1.6] |
Very low |
It may result in little to no difference in self-management behaviours |
1 |
60 |
0.31 [-0.97, 1.6] |
Low |
0.0 |
NA [NA, NA] |
NA |
11. Weight (management) / BMI - Body Mass Index |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.08 [-1.44, 1.28] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
2 |
287 |
-0.32 [-1.8, 1.16] |
Low |
2.0 |
1.28 [-2.21, 4.78] |
Low |
12. Lipid profile / Total cholesterol |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.55 [-10.47, 9.36] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
2 |
285 |
-4.68 [-16.67, 7.31] |
Low |
2.0 |
8.38 [-9.25, 26.01] |
Low |
13. Dietary habits |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
2.38 [1.6, 3.16] |
Low |
It may result in a large improvement in dietary habits |
1 |
60 |
2.38 [1.6, 3.16] |
Low |
0.0 |
N/A |
NA |
14. Lipid profile / Triglycerides |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.26 [-0.87, 0.35] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
2 |
286 |
-0.7 [-1.44, 0.03] |
Moderate |
2.0 |
0.71 [-0.38, 1.8] |
Moderate |
15. Knowledge |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.41 [-0.45, 1.26] |
Very low |
It may result in little to no difference in knowledge but the evidence is very uncertain |
1 |
217 |
0.41 [-0.56, 1.39] |
Low |
1.0 |
0.38 [-1.35, 2.11] |
Low |
16. HbA1C / Glycated hemoglobin (HbA1c) |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-0.56 [-0.89, -0.23] |
Very low |
It may decrease HbA1C levels (%) but the evidence is very uncertain |
4 |
527 |
-0.52 [-0.97, -0.06] |
Low |
4.0 |
-0.61 [-1.09, -0.13] |
Low |
17. Quality of life |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
0.13 [-0.57, 0.83] |
Very Low |
It may result in little to no difference in quality of life |
1 |
134 |
0.08 [-0.75, 0.91] |
Low |
1.0 |
0.24 [-1.05, 1.53] |
Low |
18. Lipid profile / LDL-Cholesterol |
NMA |
Direct |
Indirect |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
-2.78 [-11.92, 6.37] |
Moderate |
It likely results in little to no difference in LDL levels (mg/dL) |
1 |
109 |
-3.5 [-14.65, 7.65] |
Moderate |
1.0 |
-1.29 [-17.29, 14.72] |
Moderate |
Footnotes per outcome:
1) a) We rated down the certainty of evidence due to serious riks of bias and serious imprecision; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. 2) a) Number of studies included in the network: 14 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s) The range of follow up was from 2 to 24 months for the studies included in the whole network; b) We rated down the certainty of evidence due to very serious imprecision 3) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 51 months for the studies included in the whole network; b) We rated down the certainty of evidence due to serious imprecision 4) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 36 months for the studies included in the whole network; b) We rated down the certainty of evidence due to serious imprecision 5) a) We rated down the certainty of evidence due to very serious imprecision; b) Number of studies included in the network: 44 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 1 comparison(s).The range of follow up was from 2 to 24 months for the studies included in the whole network. 6) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 29 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=30); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 2 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care. 7) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 26 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=30); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 2 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care. 8) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=58); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 4 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias and serious imprecision 9) a) We rated down the certainty of evidence due to very serious risk of bias and very serious imprecision; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=58); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 4 months in the studies directly comparing the self-management intervention versus usual care. 10) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=30); Number of comparison(s) informing the indirect estimate: 0 comparison(s) The range of follow up was from 1 to 12 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care; b) We rated down the certainty of evidence due to very serious risk of bias and very serious imprecision 11) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=144); Number of comparison(s) informing the indirect estimate: 2 comparison(s).The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-12 months in the studies directly comparing the self-management intervention versus usual care. 12) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=142); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias and to serious inconsistency 13) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=30); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 24 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias 14) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=143); Number of comparison(s) informing the indirect estimate: 2 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious risk of bias 15) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=110); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 2 to 60 months for the studies included in the whole network. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision 16) a) We rated down the certainty of evidence due to serious imprecision, serious risk of bias and serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=267); Number of comparison(s) informing the indirect estimate: 4 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 3-12 months in the studies directly comparing the self-management intervention versus usual care. 17) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=67); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 60 months for the studies included in the whole network. The range of follow-up was 3 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to very serious imprecision and very serious risk of bias 18) a) We rated down the certainty of evidence due to serious risk of bias; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=58); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. The range of follow-up was 4 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
6) Hemmati Maslakpak-2017 7) Hemmati Maslakpak-2017 8) Taveira-2010 9) Taveira-2010 10) Hemmati Maslakpak-2017 11) Brown-2002Hemmati Maslakpak-2017 12) Brown-2002, Hemmati Maslakpak-2017 13) Hemmati Maslakpak-2017 14) Brown-2002, Hemmati Maslakpak-2017 15) Brown-2002 16) Brown-2002, Hemmati Maslakpak-2017, Taveira-2010, Wichit-2017 17) Wichit-2017 18) Brun-2008
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