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 |
1.58 [0.85, 2.31] |
Low |
It may result in a large increase in foot care self-management |
0 |
0 |
[, ] |
NA |
1.0 |
1.58 [0.85, 2.31] |
Low |
2. 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 |
0.56 [-0.37, 1.49] |
Low |
It may result in a slight improvement in dietary habits |
0 |
0 |
[, ] |
N/A |
1.0 |
0.56 [-0.37, 1.49] |
Low |
3. 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 |
1.21 [-0.51, 2.92] |
Very low |
It may increase glucose self-monitoring but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
1.21 [-0.51, 2.92] |
Low |
4. 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 |
0.42 [-0.32, 1.15] |
Very low |
It may result in little to no difference in self-efficacy but the evidence is very uncertain |
2 |
137 |
0.42 [-0.32, 1.15] |
Very low |
0.0 |
NA [NA, NA] |
NA |
5. 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 |
-2.85 [-6.5, 0.81] |
Low |
It may result in little to no difference in waist size (cm) |
2 |
94 |
-2.85 [-6.5, 0.81] |
Low |
0.0 |
NA [NA, NA] |
NA |
6. 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 |
-0.77 [-10.93, 9.39] |
Very low |
It may result in little to no difference in weight (kgs) but the evidence is very uncertain |
1 |
57 |
-0.77 [-10.93, 9.39] |
Low |
0.0 |
NA [NA, NA] |
NA |
7. 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 |
0.29 [-0.29, 0.87] |
Very low |
It may result in little to no difference in physical activity |
1 |
57 |
0.56 [-0.22, 1.34] |
Low |
1.0 |
-0.05 [-0.91, 0.82] |
Low |
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 |
0.96 [0.21, 1.7] |
Very low |
It may increase knowledge but the evidence is very uncertain |
2 |
161 |
0.96 [0.21, 1.7] |
Low |
0.0 |
NA [NA, NA] |
NA |
9. 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 |
0.1 [-0.33, 0.53] |
Low |
It may result in little to no difference in HbA1C levels (%) |
4 |
276 |
0.07 [-0.39, 0.53] |
Moderate |
2.0 |
0.3 [-0.95, 1.54] |
Moderate |
10. 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 |
-16.7 [-34.6, 1.2] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
1 |
57 |
-16.7 [-34.6, 1.2] |
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 |
-2.03 [-5.47, 1.42] |
Low |
It may result in a large increase in HDL levels (mmol/L) |
3 |
239 |
-2.03 [-5.47, 1.42] |
Low |
0.0 |
NA [NA, NA] |
NA |
12. 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 |
-0.2 [-1.16, 0.77] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
3 |
198 |
-0.2 [-1.16, 0.77] |
Low |
0.0 |
NA [NA, NA] |
NA |
13. 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 |
-0.53 [-5.39, 4.33] |
Very low |
It may decrease systolic blood pressure levels (mmHg) but the evidence is very uncertain |
4 |
276 |
-0.28 [-5.27, 4.71] |
Low |
1.0 |
-5.22 [-26.67, 16.24] |
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 |
-0.27 [-3.16, 2.63] |
Very low |
It may result in little to no difference in diastolic blood pressure(mmHg) but the evidence is very uncertain |
4 |
276 |
-0.19 [-3.23, 2.84] |
Low |
1.0 |
-1.01 [-10.57, 8.56] |
Low |
15. 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 [-1.07, 0.88] |
Moderate |
It likely results in little to no difference in triglycerides (mmol/L) |
3 |
239 |
-0.09 [-1.07, 0.88] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
16. 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 |
-8.64 [-20.71, 3.43] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
3 |
239 |
-8.64 [-20.71, 3.43] |
Low |
0.0 |
NA [NA, NA] |
NA |
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: 0 RCT(s) (N=0); 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. 2) a) Number of studies included in the network: 30 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 24 months for the studies included in the whole network; b) We rated down the certainty of evidence due to serious imprecision 3) 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: 0 RCT(s) (N=0); 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. 4) 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: 2 RCT(s) (N=68); 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 3-6 months in the studies directly comparing the self-management intervention versus usual care. 5) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=48); 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 4-6 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 risk of bias 6) a) Number of studies included in the network: 145 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 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 very serious risk of bias and very serious imprecision 7) 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: 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 6 months in the studies directly comparing the self-management intervention versus usual care. 8) a) Number of studies included in the network: 43 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=80); 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 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 and serious imprecision 9) a) We rated down the certainty of evidence due to serious imprecision and serious risk of bias; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=144); 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 1-12 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: 171 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 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. 11) 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=124); 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 1-12 months in the studies directly comparing the self-management intervention versus usual care. 12) 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: 3 RCT(s) (N=100); 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 1-6 months in the studies directly comparing the self-management intervention versus usual care. 13) a) We rated down the certainty of evidence due to serious imprecision and very serious risk of bias; b) Number of studies included in the network: 233 RCTs; Number of studies directly comparing the intervention with usual care: 4 RCT(s) (N=143); 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 1-12 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: 4 RCT(s) (N=143); 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 1-12 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 imprecision 15) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=124); 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 1-12 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 16) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 3 RCT(s) (N=124); 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 1-12 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
References of studies informing direct evidence:
4) Atak-2009, McKibbin-2006 5) Cheung-2009, McKibbin-2006 6) McKibbin-2006 7) McKibbin-2006 8) McKibbin-2006, Scain-2009 9) Cheung-2009, McKibbin-2006, Scain-2009, Weinstein-2014 10) Lim-2011 11) McKibbin-2006, Scain-2009, Weinstein-2014 12) Cheung-2009, McKibbin-2006, Scain-2009 13) DeJesus-2009McKibbin-2006Scain-2009Weinstein-2014 14) DeJesus-2009McKibbin-2006Scain-2009Weinstein-2014 15) McKibbin-2006, Scain-2009, Weinstein-2014 16) McKibbin-2006, Scain-2009, Weinstein-2014
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