1. 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 |
0.82 [0.18, 1.46] |
Very Low |
It may increase quality of life but the evidence is very uncertain |
1 |
100 |
0.72 [-0.14, 1.58] |
Low |
1.0 |
0.95 [-0.01, 1.91] |
Low |
2. 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 |
-2.95 [-5.92, 0.01] |
Very low |
It may result in little to no difference in LDL levels (mg/dL) |
5 |
1376 |
0.14 [-3.58, 3.86] |
Low |
6.0 |
-8.37 [-13.29, -3.45] |
Low |
3. 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 |
-2.58 [-4.71, -0.46] |
Very low |
It may decrease diastolic blood pressure(mmHg) but the evidence is very uncertain |
2 |
76 |
-1.13 [-4.44, 2.17] |
Low |
4.0 |
-3.6 [-6.37, -0.83] |
Low |
4. 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 |
-0.27 [-2.51, 1.97] |
Low |
It may result in a slight increase in HDL levels (mmol/L) |
4 |
345 |
-1.16 [-3.82, 1.5] |
Low |
3.0 |
1.88 [-2.25, 6.0] |
Low |
5. 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 |
-4.29 [-8.0, -0.57] |
Very low |
It may result in little to no difference in systolic blood pressure levels (mmHg) but the evidence is very uncertain |
3 |
101 |
-3.72 [-9.04, 1.61] |
Low |
5.0 |
-4.83 [-10.02, 0.36] |
Low |
6. 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 |
-0.82 [-1.21, -0.42] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
3 |
300 |
-0.28 [-0.79, 0.23] |
Moderate |
2.0 |
-1.59 [-2.2, -0.97] |
Moderate |
7. 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 [-1.01, 1.7] |
Very low |
It may result in little to no difference in self-management behaviours |
1 |
35 |
0.35 [-1.01, 1.7] |
Low |
0.0 |
NA [NA, NA] |
NA |
8. 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 |
-0.44 [-1.9, 1.03] |
Low |
It may result in little to no difference in weight (kgs) |
4 |
456 |
-2.15 [-4.21, -0.09] |
Low |
4.0 |
1.31 [-0.76, 3.39] |
Low |
9. 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 |
-2.83 [-4.82, -0.85] |
Low |
It may result in little to no difference in waist size (cm) |
4 |
384 |
-3.23 [-5.25, -1.2] |
Low |
4.0 |
6.46 [-3.37, 16.3] |
Low |
10. 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 |
0.86 [0.26, 1.47] |
Very low |
It may result in little to no difference in adherence but the evidence is very uncertain |
4 |
1338 |
0.84 [0.21, 1.47] |
Very low |
3.0 |
1.13 [-0.97, 3.23] |
Very low |
11. 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 |
-0.17 [-0.35, 0.01] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
10 |
1649 |
-0.25 [-0.5, 0.0] |
Very low |
8.0 |
-0.08 [-0.34, 0.17] |
Very 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 |
1.83 [-4.95, 8.62] |
Very low |
It may result in little to no difference in total cholesterol (mg/dL) |
4 |
345 |
-3.15 [-11.59, 5.29] |
Low |
2.0 |
10.9 [-0.49, 22.29] |
Low |
13. 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 |
0.22 [-0.81, 1.25] |
Very low |
It may result in little to no difference in glucose self-monitoring but the evidence is very uncertain |
1 |
87 |
0.22 [-0.81, 1.25] |
Low |
0.0 |
NA [NA, NA] |
NA |
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 |
0.81 [-0.22, 1.83] |
Very low |
It may increase knowledge but the evidence is very uncertain |
1 |
100 |
0.81 [-0.22, 1.83] |
Low |
0.0 |
NA [NA, NA] |
NA |
15. 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 |
0.28 [-0.19, 0.74] |
Very low |
It may result in little to no difference in dietary habits but the evidence is very uncertain |
2 |
122 |
0.28 [-0.19, 0.74] |
Very low |
0.0 |
N/A |
NA |
16. 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 |
0.78 [0.31, 1.25] |
Very low |
It may increase physical activity |
2 |
122 |
0.58 [0.03, 1.14] |
Very low |
2.0 |
1.29 [0.41, 2.18] |
Very low |
17. 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 |
-0.31 [-1.17, 0.55] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
1 |
35 |
-0.31 [-1.17, 0.55] |
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 |
-0.84 [-1.64, -0.04] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
4 |
271 |
-0.88 [-1.69, -0.06] |
Low |
2.0 |
0.11 [-4.19, 4.41] |
Low |
Footnotes per outcome:
1) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=52); 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 serious imprecision 2) 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: 171 RCTs; Number of studies directly comparing the intervention with usual care: 5 RCT(s) (N=690); 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 3-18 months in the studies directly comparing the self-management intervention versus usual care. 3) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=40); 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 3-4 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 serious imprecision 4) 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: 4 RCT(s) (N=172); 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 2-12 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: 233 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=52); 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 3-6 months in the studies directly comparing the self-management intervention versus usual care. 6) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=148); 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 7) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=16); 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 8) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=231); Number of comparison(s) informing the indirect estimate: 4 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 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.. 9) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=194); 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 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 very serious risk of bias and very serious risk of bias 10) a) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=670); Number of comparison(s) informing the indirect estimate: 3 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 1-18 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, very serious risk of bias, and serious inconsistency 11) 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: 463 RCTs; Number of studies directly comparing the intervention with usual care: 10 RCT(s) (N=828); Number of comparison(s) informing the indirect estimate: 8 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. 12) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=172); 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, serious incoherence and to serious inconsistency 13) 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=44); 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. 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=52); 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 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 serious imprecision 15) a) Number of studies included in the network: 30 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=60); 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, serious inconsistency, and serious imprecision 16) 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: 64 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=60); Number of comparison(s) informing the indirect estimate: 2 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. 17) 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: 44 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=16); 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. 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: 4 RCT(s) (N=137); 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 3-6 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
1) Kv-2011 2) Al-Shookri-2012Gram-2010Pladevall-2015Trief-2011Wolf-2004 3) Gram-2010Li-2018a 4) Al-Shookri-2012, Gram-2010, Phumipamorn-2008, Wolf-2004 5) Gram-2010Li-2018aTrief-2011 6) Al-Shookri-2012, Phumipamorn-2008, Wolf-2004 7) Rees-2017 8) Al-Shookri-2012, Bowen-2016, Gram-2010, Wolf-2004 9) Al-Shookri-2012, Gram-2010, Trief-2011, Wolf-2004 10) Nascimentoa-2015, Negarandeh-2013, Pladevall-2015, Trief-2011 11) Bowen-2016, Gram-2010, Li-2018a, Nascimentoa-2015, Nishihara-2017, Pladevall-2015, Rees-2017, Trief-2011, Wolf-2004 12) Al-Shookri-2012, Gram-2010, Phumipamorn-2008, Wolf-2004 13) Nascimentoa-2015 14) Kv-2011 15) Nascimentoa-2015, Rees-2017 16) Nascimentoa-2015, Rees-2017 17) Rees-2017 18) Al-Shookri-2012, Gram-2010, Li-2018a, Trief-2011
|