| 1. 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 |
| -0.07 [-0.88, 0.74] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
0 |
0 |
[, ] |
NA |
1.0 |
-0.07 [-0.88, 0.74] |
Moderate |
| 2. 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 |
| 0.02 [-0.77, 0.81] |
Very Low |
It may result in little to no difference in quality of life but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
0.02 [-0.77, 0.81] |
Low |
| 3. 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 |
| 1.12 [-2.03, 4.27] |
Very low |
It may result in a large decrease in HDL levels (mmol/L) |
0 |
0 |
[, ] |
NA |
4.0 |
1.12 [-2.03, 4.27] |
Low |
| 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 |
| -1.55 [-8.83, 5.73] |
Moderate |
It likely results in little to no difference in LDL levels (mg/dL) |
0 |
0 |
[, ] |
NA |
2.0 |
-1.55 [-8.83, 5.73] |
0 |
| 5. 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 |
| -0.16 [-1.55, 1.24] |
Very low |
It may result in little to no difference in fat consumption |
1 |
263 |
-0.16 [-1.55, 1.24] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 6. 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 |
| -0.39 [-0.69, -0.09] |
Very low |
It may result in little to no difference in foot care self-management but the evidence is very uncertain |
1 |
263 |
-0.39 [-0.69, -0.09] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 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 |
| -0.15 [-0.94, 0.65] |
Very low |
It may result in little to no difference in glucose self-monitoring but the evidence is very uncertain |
1 |
263 |
-0.08 [-1.05, 0.89] |
Low |
1.0 |
-0.29 [-1.66, 1.09] |
Low |
| 8. Physical activity / Steps/day |
| 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 [-0.48, 0.3] |
Low |
It may result in little to no difference in steps per day |
1 |
157 |
-0.09 [-0.48, 0.3] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 9. 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 |
| -6.85 [-12.78, -0.93] |
Moderate |
It likely results in little to no difference on total cholesterol (mg/dL) |
1 |
616 |
-0.5 [-10.88, 9.88] |
Moderate |
4.0 |
-9.92 [-17.14, -2.71] |
Moderate |
| 10. 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 [-0.71, 0.26] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
1 |
157 |
-0.03 [-0.66, 0.59] |
Low |
3.0 |
-0.51 [-1.27, 0.26] |
Low |
| 11. 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 |
| 0.34 [-2.0, 2.69] |
Moderate |
It likely results in little to no difference in waist size (cm) |
1 |
616 |
0.9 [-2.08, 3.87] |
Moderate |
4.0 |
-0.57 [-4.38, 3.24] |
Moderate |
| 12. 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 |
| -0.21 [-0.83, 0.41] |
Very low |
It may result in little to no difference in physical activity |
1 |
263 |
-0.21 [-0.83, 0.41] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 13. 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 |
| -0.29 [-0.97, 0.38] |
Very low |
It may result in little to no difference in body mass index (kg/m²) but the evidence is very uncertain |
1 |
287 |
0.7 [-0.51, 1.91] |
Low |
4.0 |
-0.74 [-1.56, 0.07] |
Low |
| 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 |
| -0.03 [-1.71, 1.64] |
Moderate |
It likely results in little to no difference in diastolic blood pressure (mmHg) |
3 |
1166 |
-0.23 [-2.33, 1.88] |
Moderate |
4.0 |
0.3 [-2.46, 3.07] |
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 |
| 0.52 [-2.51, 3.55] |
Very low |
It may result in a large decrease in systolic blood pressure levels (mmHg) but the evidence is very uncertain |
3 |
1166 |
-0.56 [-4.75, 3.63] |
Low |
4.0 |
1.71 [-2.67, 6.1] |
Low |
| 16. Adherence / Medication (or other treatment) adherence |
| 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 [-1.67, 1.59] |
Very low |
It likely results in little to no difference in adherence |
2 |
407 |
-0.04 [-1.67, 1.59] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
| 17. 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 |
| 0.08 [-1.66, 1.83] |
Moderate |
It likely results in little to no difference on weight (kgs) |
1 |
616 |
0.57 [-2.8, 3.93] |
Moderate |
3.0 |
-0.09 [-2.14, 1.95] |
Moderate |
| 18. 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 |
| 0.24 [-0.98, 1.46] |
Very low |
It may result in little to no difference in self-management behaviours |
1 |
157 |
0.24 [-0.98, 1.46] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 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 |
| -0.36 [-0.58, -0.14] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
5 |
1467 |
-0.26 [-0.59, 0.07] |
Low |
6.0 |
-0.44 [-0.73, -0.15] |
Low |
| 20. 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 |
| 0.25 [-0.72, 1.22] |
Very low |
It may result in little to no difference in self-efficacy |
1 |
157 |
0.25 [-0.72, 1.22] |
Low |
0.0 |
NA [NA, NA] |
NA |
Footnotes per outcome:
1) a) Number of studies included in the network: 171 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; b) We rated down the certainty of evidence due to serious risk of bias
2) 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 60 months for the studies included in the whole network; b) We rated down the certainty of evidence due to very serious imprecision
3) 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: 4 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network.
4) 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: 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 96 months for the studies included in the whole network.
5) a) Number of studies included in the network: 14 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=122); 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 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 very serious imprecision
6) 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=122); 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 12 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 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=122); 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. The range of follow-up was 12 months in the studies directly comparing the self-management intervention versus usual care.
8) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 7 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=83); Number of comparison(s) informing the indirect estimate: 0 comparison(s). The range of follow up was from 3 to 12 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.
9) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=333); 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 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
10) a) We rated down the certainty of evidence due to serious imprecision; b) Number of studies included in the network: 44 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=83); Number of comparison(s) informing the indirect estimate: 3 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.
11) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=333); Number of comparison(s) informing the indirect estimate: 4 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 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 serious risk of bias
12) 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=122); 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 12 months in the studies directly comparing the self-management intervention versus usual care.
13) a) We rated down the certainty of evidence due to very serious risk of bias and serious incoherence; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=145); 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 12 months in the studies directly comparing the self-management intervention versus usual care.
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=600); 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 12-12 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) We rated down the certainty of evidence due to very serious risk of bias and serious incoherence; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=600); 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 12-12 months in the studies directly comparing the self-management intervention versus usual care.
16) a) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=195); 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 12-24 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 serious risk of bias
17) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=333); 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 12 months in the studies directly comparing the self-management intervention versus usual care.; b) We rated down the certainty of evidence due to..
18) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=83); 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 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 very serious imprecision
19) 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: 5 RCT(s) (N=756); Number of comparison(s) informing the indirect estimate: 6 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 6-24 months in the studies directly comparing the self-management intervention versus usual care.
20) 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: 55 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=83); 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.
References of studies informing direct evidence:
5) Ayala-2015
6) Ayala-2015
7) Ayala-2015
8) McEwen-2017
9) Yu-2018
10) McEwen-2017
11) Yu-2018
12) Ayala-2015
13) Nelson-2017
14) Ayala-2015Nelson-2017Yu-2018
15) Ayala-2015Nelson-2017Yu-2018
16) Ayala-2015, Rothschild-2014
17) Yu-2018
18) McEwen-2017
19) Ayala-2015, McEwen-2017, Nelson-2017, Rothschild-2014, Yu-2018
20) McEwen-2017
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