| 1. 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 |
| 1.31 [0.84, 1.78] |
Low |
It may result in a large increase in foot care self-management |
1 |
101 |
1.31 [0.84, 1.78] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 2. 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 |
| 0.73 [-0.29, 1.76] |
Very low |
It may increase glucose self-monitoring but the evidence is very uncertain |
1 |
101 |
0.73 [-0.29, 1.76] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 3. 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 |
| 0.25 [-0.8, 1.29] |
Very Low |
It may result in little to no difference in quality of life |
1 |
30 |
0.25 [-0.8, 1.29] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 4. 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 |
| 0.87 [0.17, 1.57] |
Very low |
It may increase physical activity |
1 |
101 |
0.87 [0.17, 1.57] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 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 |
| -0.3 [-0.87, 0.28] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
1 |
411 |
-0.3 [-0.87, 0.28] |
Low |
0.0 |
Na [NA, NA] |
NA |
| 6. 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 |
| 1.3 [0.72, 1.88] |
Low |
It may result in a large improvement in dietary habits |
1 |
101 |
1.3 [0.72, 1.88] |
Low |
0.0 |
N/A |
NA |
| 7. Experience of care / Care satisfaction |
| 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 |
| 0.5 [-1.29, 2.3] |
Very low |
It may increase care satisfaction but the evidence is very uncertain |
1 |
411 |
0.5 [-1.29, 2.3] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 8. 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 |
| -0.76 [-2.77, 1.24] |
Low |
It likely results in little to no difference in waist size (cm) |
1 |
0 |
-1.31 [-4.07, 1.45] |
Low |
3.0 |
-0.15 [-3.08, 2.78] |
Moderate |
| 9. 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 |
| -2.53 [-6.1, 1.04] |
Very low |
It may result in little to no difference in LDL levels (mg/dL) |
4 |
163 |
0.04 [-4.19, 4.26] |
Low |
1.0 |
-8.92 [-15.6, -2.24] |
Low |
| 10. 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 |
| -1.63 [-4.13, 0.87] |
Low |
It may result in a large increase in HDL levels (mmol/L) |
3 |
166 |
-1.36 [-4.34, 1.61] |
Low |
1.0 |
-2.27 [-6.88, 2.34] |
Moderate |
| 11. 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 |
| -5.16 [-11.92, 1.61] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
3 |
166 |
-4.28 [-12.43, 3.87] |
Low |
1.0 |
-7.11 [-19.25, 5.02] |
Moderate |
| 12. 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 |
| 0.09 [-0.27, 0.45] |
Low |
It may result in little to no difference in triglycerides (mmol/L) |
4 |
166 |
0.17 [-0.28, 0.61] |
Low |
1.0 |
-0.06 [-0.69, 0.57] |
Moderate |
| 13. 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 |
| 0.42 [-0.79, 1.63] |
Low |
It may result in little to no difference in weight (kgs) but the evidence is very uncertain |
2 |
0 |
0.27 [-1.21, 1.75] |
Very low |
1.0 |
0.74 [-1.38, 2.85] |
Moderate |
| 14. 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 |
| 1.48 [0.44, 2.51] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
101 |
1.48 [0.44, 2.51] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 15. 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 |
| -0.84 [-3.22, 1.54] |
Very low |
It may result in little to no difference in diastolic blood pressure (mmHg) but the evidence is very uncertain |
2 |
63 |
-1.2 [-4.53, 2.12] |
Low |
1.0 |
-0.47 [-3.87, 2.94] |
Moderate |
| 16. 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 |
| -1.46 [-5.19, 2.28] |
Very low |
It may decrease systolic blood pressure levels (mmHg) but the evidence is very uncertain |
3 |
63 |
0.53 [-4.11, 5.17] |
Low |
1.0 |
-5.12 [-11.42, 1.18] |
Low |
| 17. 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 |
| 0.9 [-0.33, 2.13] |
Very low |
It may result in little to no difference in adherence |
1 |
101 |
0.9 [-0.33, 2.13] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 18. 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 |
| 0.26 [-0.23, 0.75] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
5 |
512 |
0.21 [-0.37, 0.79] |
Low |
1.0 |
0.4 [-0.55, 1.35] |
Low |
| 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 |
| -0.07 [-0.33, 0.19] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
6 |
166 |
0.04 [-0.25, 0.33] |
Very low |
1.0 |
-0.41 [-0.93, 0.11] |
Very low |
Footnotes per outcome:
1) 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=50); 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.
2) 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: 1 RCT(s) (N=50); 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.
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=15); Number of comparison(s) informing the indirect estimate: 0 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 0 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
4) 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=50); 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.
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: 44 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=214); 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.
6) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=50); 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
7) a) Number of studies included in the network: 13 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=214); Number of comparison(s) informing the indirect estimate: 0 comparison(s) The range of follow up was from 3 to 14 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
8) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=780); Number of comparison(s) informing the indirect estimate: 3 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 18 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
9) a) We rated down the certainty of evidence due to very serious risk of bias an serious incoherence; b) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=85); 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 6-18 months in the studies directly comparing the self-management intervention versus usual care.
10) a) We rated down the certainty of evidence due to very serious risk of bias; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=86); 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 6-12 months in the studies directly comparing the self-management intervention versus usual care.
11) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=86); 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 6-18 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
12) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=86); 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 6-18 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
13) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=897); Number of comparison(s) informing the indirect estimate: 1 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 6-18 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 inconsistency
14) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=50); 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
15) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=36); 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 12-18 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, 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=36); 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 6-18 months in the studies directly comparing the self-management intervention versus usual care.
17) a) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=50); 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 serious imprecision and very serious risk of bias
18) 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=264); 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 6-18 months in the studies directly comparing the self-management intervention versus usual care.
19) a) We rated down the certainty of evidence due to very serious risk of bias, serious incoherence and serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 6 RCT(s) (N=86); 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 3-18 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
1) Wishah-2015
2) Wishah-2015
3) Simson-2008
4) Wishah-2015
5) Siaw-2017
6) Wishah-2015
7) Siaw-2017
8) Chapman-2018
9) Kraemer-2012Wishah-2015Chapman-2018Siaw-2017
10) Kraemer-2012, Wishah-2015, Chapman-2018
11) Kraemer-2012, Wishah-2015, Chapman-2018
12) Kraemer-2012, Wishah-2015, Chapman-2018, Siaw-2017, Bunner-2015
13) Chapman-2018, Teychenne-2015
14) Wishah-2015
15) Kraemer-2012Chapman-2018
16) Kraemer-2012Chapman-2018Siaw-2017
17) Wishah-2015
18) Siaw-2017, Wishah-2015, Chapman-2018, Shi-2018, Teychenne-2015
19) Kraemer-2012, Wishah-2015, Chapman-2018, Shi-2018, Siaw-2017, Teychenne-2015
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