1. 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 |
0.35 [-0.2, 0.9] |
Very low |
It may result in little to no difference in self-management behaviours but the evidence is very uncertain |
5 |
693 |
0.35 [-0.2, 0.9] |
Very low |
0.0 |
NA [NA, NA] |
NA |
2. Self-efficacy |
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 |
0.67 [0.29, 1.05] |
Very low |
It may increase self-efficacy but the evidence is very uncertain |
7 |
992 |
0.67 [0.29, 1.05] |
Very low |
0.0 |
NA [NA, NA] |
NA |
3. 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 |
-9.5 [-15.9, -3.1] |
Very low |
It may decrease waist size (cm) but the evidence is very uncertain |
1 |
53 |
-9.5 [-15.9, -3.1] |
Low |
0.0 |
NA [NA, NA] |
NA |
4. 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 |
-5.23 [-11.12, 0.66] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
3 |
483 |
-5.23 [-11.12, 0.66] |
Low |
0.0 |
NA [NA, NA] |
NA |
5. 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 |
1.05 [-1.62, 3.72] |
Low |
It may result in a large decrease in HDL levels (mmol/L) |
3 |
483 |
0.81 [-2.07, 3.68] |
Low |
1.0 |
2.6 [-4.57, 9.77] |
Low |
6. 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 |
0.15 [-0.28, 0.58] |
Low |
It likely results in little to no difference on quality of life |
3 |
354 |
0.02 [-0.47, 0.52] |
Moderate |
2.0 |
0.53 [-0.32, 1.38] |
Moderate |
7. 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 |
0.38 [-0.71, 1.46] |
Very low |
It may result in little to no difference in glucose self-monitoring but the evidence is very uncertain |
1 |
53 |
0.38 [-0.71, 1.46] |
Low |
0.0 |
NA [NA, NA] |
NA |
8. 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 |
-3.56 [-9.92, 2.8] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
4 |
735 |
-3.56 [-9.92, 2.8] |
Low |
0.0 |
NA [NA, NA] |
NA |
9. 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 |
-0.03 [-0.4, 0.35] |
Low |
It may result in little to no difference in psychological distress |
3 |
460 |
-0.03 [-0.4, 0.35] |
Low |
0.0 |
NA [NA, NA] |
NA |
10. 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 |
0.44 [-0.23, 1.11] |
Very low |
It may result in little to no difference in dietary habits |
1 |
53 |
0.44 [-0.23, 1.11] |
Low |
0.0 |
N/A |
NA |
11. 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 |
-0.09 [-0.66, 0.47] |
Very low |
It may result in little to no difference in foot care self-management but the evidence is very uncertain |
1 |
53 |
-0.09 [-0.66, 0.47] |
Low |
0.0 |
NA [NA, NA] |
NA |
12. 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 |
-0.45 [-2.51, 1.6] |
Low |
It may result in little to no difference in weight (kgs) but the evidence is very uncertain |
3 |
244 |
-0.73 [-4.07, 2.62] |
Very low |
3.0 |
-0.28 [-2.89, 2.32] |
Very low |
13. 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 |
1.56 [0.44, 2.69] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
53 |
1.56 [0.44, 2.69] |
Low |
0.0 |
NA [NA, NA] |
NA |
14. 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 |
-2.02 [-3.87, -0.16] |
Low |
It may result in little to no difference in diastolic blood pressure (mmHg) |
3 |
483 |
-2.46 [-4.54, -0.38] |
Moderate |
2.0 |
-0.25 [-4.4, 3.89] |
Moderate |
15. 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 |
-2.56 [-6.24, 1.11] |
Very low |
It may increase systolic blood pressure levels (mmHg) but the evidence is very uncertain |
3 |
483 |
-2.75 [-6.92, 1.42] |
Very low |
2.0 |
-1.9 [-9.67, 5.86] |
Very low |
16. 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 |
-0.37 [-0.86, 0.12] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
5 |
512 |
-0.32 [-0.9, 0.27] |
Low |
4.0 |
-0.5 [-1.41, 0.4] |
Low |
17. Physical activity |
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 |
0.45 [-0.34, 1.24] |
Very low |
It may result in little to no difference in physical activity |
1 |
53 |
0.45 [-0.34, 1.24] |
Low |
0.0 |
NA [NA, NA] |
NA |
18. 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 |
-0.13 [-0.64, 0.38] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
1 |
180 |
-0.02 [-0.62, 0.58] |
Moderate |
1.0 |
-0.4 [-1.37, 0.57] |
Moderate |
19. 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 |
-0.44 [-0.63, -0.24] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
10 |
1672 |
-0.44 [-0.67, -0.21] |
Very low |
5.0 |
-0.44 [-0.8, -0.08] |
Very low |
Footnotes per outcome:
1) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=346); 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 1-6 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, very serious inconsistency and serious imprecision 2) a) We rated down the certainty of evidence due to very serious risk of bias, serious inconsistency and serious imprecision; b) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 7 RCT(s) (N=491); 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 1-6 months in the studies directly comparing the self-management intervention versus usual care. 3) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=28); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 1 to 36 months for the studies included in the whole network. The range of follow-up was 6 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 4) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=240); Number of comparison(s) informing the indirect estimate: 0 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 5-9 months in the studies directly comparing the self-management intervention versus usual care. 5) a) We rated down the certainty of evidence due to serious risk of bias and serious inconsistency; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=240); 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 5-9 months in the studies directly comparing the self-management intervention versus usual care. 6) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=182); Number of comparison(s) informing the indirect estimate: 2 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 5-6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to serious imprecision and serious risk of bias 7) 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: 29 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=28); 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 6 months in the studies directly comparing the self-management intervention versus usual care. 8) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=364); Number of comparison(s) informing the indirect estimate: 0 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 5-12 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 9) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 44 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=224); 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 5-6 months in the studies directly comparing the self-management intervention versus usual care. 10) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=28); 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 6 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 11) a) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision; b) Number of studies included in the network: 26 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=28); 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 6 months in the studies directly comparing the self-management intervention versus usual care. 12) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=127); Number of comparison(s) informing the indirect estimate: 3 comparison(s). The range of follow up was from 1 to 51 months for the studies included in the whole network. The range of follow-up was 6 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to.. 13) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=28); Number of comparison(s) informing the indirect estimate: 0 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 6 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 14) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=240); 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 5-9 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 15) a) We rated down the certainty of evidence due to serious imprecision, very serious risk of bias and serious inconsistency; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=240); 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 5-9 months in the studies directly comparing the self-management intervention versus usual care. 16) 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: 5 RCT(s) (N=259); 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 6-9 months in the studies directly comparing the self-management intervention versus usual care. 17) a) We rated down the certainty of evidence due to very serious risk of bias and serious imprecision; b) Number of studies included in the network: 64 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=28); 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 6 months in the studies directly comparing the self-management intervention versus usual care. 18) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=88); 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 9 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 19) a) We rated down the certainty of evidence due to serious imprecision, serious risk of bias and very serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 10 RCT(s) (N=840); Number of comparison(s) informing the indirect estimate: 5 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 5-12 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
1) Azami-2018, Kasteleyn-2016, Shi-2010, Taveira-2011, Wu-2011 2) Azami-2018, Kasteleyn-2016, Shi-2010, Sigurdardottir-2009, Sturt-2008, Taveira-2011, Wu-2011 3) Sigurdardottir-2009 4) Azami-2018Kasteleyn-2016Withidpanyawong-2018 5) Azami-2018, Kasteleyn-2016, Withidpanyawong-2018 6) Azami-2018, Huisman-2009, Kasteleyn-2016 7) Sigurdardottir-2009 8) Azami-2018, Kasteleyn-2016, Rosal-2011, Withidpanyawong-2018 9) Kasteleyn-2016; Sigurdardottir-2009; Sturt-2008 10) Sigurdardottir-2009 11) Sigurdardottir-2009 12) Azami-2018, Huisman-2009, Sigurdardottir-2009 13) Sigurdardottir-2009 14) Azami-2018Kasteleyn-2016Withidpanyawong-2018 15) Azami-2018Kasteleyn-2016Withidpanyawong-2018 16) Azami-2018, Huisman-2009, Sigurdardottir-2009, Taveira-2011, Withidpanyawong-2018 17) Sigurdardottir-2009 18) Withidpanyawong-2018 19) Azami-2018, Dobler-2018, Huisman-2009, Kasteleyn-2016, Rosal-2011, Sigurdardottir-2009, Sturt-2008, Taveira-2011, Unknown-2004, Withidpanyawong-2018
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