1. 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 |
2.41 [-5.72, 10.53] |
Very low |
It may result in little to no difference in diastolic blood pressure(mmHg) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
2.41 [-5.72, 10.53] |
Low |
2. 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 |
1.66 [-13.8, 17.12] |
Very low |
It may decrease systolic blood pressure levels (mmHg) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
1.66 [-13.8, 17.12] |
Very low |
3. 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 |
-7.93 [-21.39, 5.52] |
Moderate |
It likely results in little to no difference on total cholesterol (mg/dL) |
1 |
96 |
-3.13 [-19.89, 13.63] |
Moderate |
1.0 |
-16.64 [-39.19, 5.91] |
Low |
4. 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 |
-0.27 [-0.98, 0.44] |
Low |
It may result in little to no difference in triglycerides (mmol/L) |
1 |
96 |
0.45 [-0.6, 1.5] |
Moderate |
2.0 |
-0.89 [-1.87, 0.08] |
Low |
5. 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 |
0.4 [-0.31, 1.1] |
Very low |
It may result in little to no difference in glucose self-monitoring but the evidence is very uncertain |
2 |
376 |
0.4 [-0.31, 1.1] |
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 |
1.09 [0.78, 1.39] |
Low |
It may increase foot care self-management |
1 |
280 |
1.09 [0.78, 1.39] |
Low |
0.0 |
NA [NA, NA] |
NA |
7. 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 |
0.21 [-0.25, 0.66] |
Very low |
It may result in little to no difference in dietary habits |
1 |
280 |
0.21 [-0.25, 0.66] |
Low |
0.0 |
N/A |
NA |
8. 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 |
0.78 [-0.19, 1.75] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
280 |
0.78 [-0.19, 1.75] |
Low |
0.0 |
NA [NA, NA] |
NA |
9. 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 |
0.16 [-0.36, 0.69] |
Very low |
It may result in little to no difference in physical activity |
1 |
280 |
0.37 [-0.25, 0.98] |
Low |
1.0 |
-0.39 [-1.39, 0.62] |
Low |
10. 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 |
-1.17 [-3.6, 1.26] |
Low |
It may result in little to no difference in waist size (cm) |
1 |
48 |
-1.17 [-3.6, 1.26] |
Low |
0.0 |
NA [NA, NA] |
NA |
11. 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 |
3.62 [-2.71, 9.95] |
Moderate |
It likely results in a large decrease in HDL levels (mmol/L) |
1 |
96 |
3.62 [-2.71, 9.95] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
12. 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 |
-1.96 [-11.49, 7.57] |
Moderate |
It likely results in little to no difference in LDL levels (mg/dL) |
1 |
96 |
-1.96 [-11.49, 7.57] |
Moderate |
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 |
-0.62 [-1.47, 0.23] |
Very low |
It may result in little to no difference in body mass index (kg/m²) but the evidence is very uncertain |
2 |
171 |
-0.86 [-1.74, 0.03] |
Very low |
2.0 |
2.38 [-0.78, 5.53] |
Very low |
14. 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 |
-0.52 [-0.87, -0.17] |
Very low |
It may decrease HbA1C levels (%) but the evidence is very uncertain |
4 |
541 |
-0.49 [-0.9, -0.07] |
Very low |
3.0 |
-0.6 [-1.25, 0.05] |
Very low |
Footnotes per outcome:
1) a) Number of studies included in the network: 211 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 very serious risk of bias and very serious imprecision 2) a) We rated down down the certainty of evidence due to very serious imprecision and serious risk of bias; 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 1 to 96 months for the studies included in the whole network. 3) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=49); 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 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 risk of bias 4) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=49); 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 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 risk of bias and serious incoherence 5) 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: 29 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=189); 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 2-6 months in the studies directly comparing the self-management intervention versus usual care. 6) 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=140); 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 2 months in the studies directly comparing the self-management intervention versus usual care. 7) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=140); 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 2 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 8) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=140); 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 2 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 9) 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=140); Number of comparison(s) informing the indirect estimate: 1 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 2 months in the studies directly comparing the self-management intervention versus usual care. 10) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=25); 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 4 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 risk of bias 11) a) We rated down the certainty of evidence due to serious risk of bias; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=49); 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 6 months in the studies directly comparing the self-management intervention versus usual care. 12) 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=49); 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 6 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 inconsistency; b) Number of studies included in the network: 231 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=86); 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 4-8 months in the studies directly comparing the self-management intervention versus usual care. 14) 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: 463 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=280); Number of comparison(s) informing the indirect estimate: 3 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 4-18 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
3) Torabizadeh-2018 4) Torabizadeh-2018 5) Shakibazadeh-2016; Torabizadeh-2018 6) Shakibazadeh-2016 7) Shakibazadeh-2016 8) Shakibazadeh-2016 9) Shakibazadeh-2016 10) Yoo-2007 11) Torabizadeh-2018 12) Plotnikoff-2013 13) Samadi-2011, Yoo-2007 14) Lee-2011, Shakibazadeh-2016, Torabizadeh-2018, Yoo-2007
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