| 1. 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 |
| -7.5 [-15.14, 0.14] |
Low |
It may result in little to no difference in waist size (cm) |
0 |
0 |
[, ] |
NA |
2.0 |
-7.5 [-15.14, 0.14] |
Low |
| 2. 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 |
| 0.05 [-0.98, 1.09] |
Very low |
It may result in little to no difference in physical activity |
0 |
0 |
[, ] |
NA |
1.0 |
0.05 [-0.98, 1.09] |
Low |
| 3. 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 |
| -0.57 [-1.6, 0.45] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
0 |
0 |
[, ] |
NA |
2.0 |
-0.57 [-1.6, 0.45] |
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 |
| -5.23 [-19.95, 9.49] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
0 |
0 |
[, ] |
NA |
1.0 |
-5.23 [-19.95, 9.49] |
0 |
| 5. 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 |
| -0.15 [-4.18, 3.88] |
Very low |
It may result in little to no difference in diastolic blood pressure(mmHg) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
-0.15 [-4.18, 3.88] |
Low |
| 6. 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 |
| -1.35 [-8.42, 5.73] |
Very low |
It may decrease systolic blood pressure levels (mmHg) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
-1.35 [-8.42, 5.73] |
Very low |
| 7. Long-term complications / Long term complications |
| NMA |
Direct |
Indirect |
| Anticipated absolute effects (95% CI) - Difference |
Certainty of the evidence |
Interpretation of findings |
Number of studies |
Number of patients |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
Number of comparisons informing indirect evidence |
Relative effects (95% CI) - Difference |
Certainty of the evidence |
| -132.38 [-96.57, 1.56256284408334016E17] |
Very low |
It may decrease long term complications incidence but the evidence is very uncertain |
1 |
59 |
-2.8847 [-40.0437, 34.2743] |
Low |
0.0 |
N/A |
NA |
| 8. 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 [-1.58, 5.63] |
Moderate |
It likely results in a large decrease in HDL levels (mmol/L) |
1 |
157 |
2.6 [-1.77, 6.97] |
Moderate |
1.0 |
0.81 [-5.57, 7.18] |
Moderate |
| 9. 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 |
| -0.16 [-0.71, 0.39] |
Low |
It may result in little to no difference in triglycerides (mmol/L) |
1 |
108 |
-0.3 [-0.99, 0.39] |
Low |
1.0 |
0.08 [-0.83, 0.99] |
Low |
| 10. 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 |
| 2.73 [1.99, 3.47] |
Low |
It may result in a large increase in foot care self-management |
1 |
59 |
2.73 [1.99, 3.47] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 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 |
| -0.42 [-0.78, -0.05] |
Low |
It may result in little to no difference in HbA1C levels (%) |
2 |
216 |
-0.6 [-1.28, 0.07] |
Moderate |
3.0 |
-0.34 [-0.78, 0.1] |
Moderate |
| 12. 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 |
| 0.03 [-1.18, 1.24] |
Very low |
It may result in little to no difference in adherence |
1 |
157 |
0.03 [-1.18, 1.24] |
Low |
0.0 |
NA [NA, NA] |
NA |
| 13. 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 |
| -0.91 [-13.82, 12.0] |
Moderate |
It likely results in little to no difference on total cholesterol (mg/dL) |
1 |
157 |
-0.91 [-13.82, 12.0] |
Moderate |
0.0 |
NA [NA, NA] |
NA |
Footnotes per outcome:
1) 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 36 months for the studies included in the whole network; 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 very serious imprecision; b) Number of studies included in the network: 64 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.
3) 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: 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.
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: 1 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: 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: 2 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
6) 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: 2 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network.
7) a) This estimate is a result of a pairwise meta-analysis (1 RCT, N=59); The range of follow-up was 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 risk of bias and very serious imprecision
8) 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=79); 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 months in the studies directly comparing the self-management intervention versus usual care.
9) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=54); 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 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
10) 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=30); 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 24 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 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: 2 RCT(s) (N=109); 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 12-24 months in the studies directly comparing the self-management intervention versus usual care.
12) a) Number of studies included in the network: 55 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=79); 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.; b) We rated down the certainty of evidence due to very serious imprecision and very serious risk of bias
13) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=79); 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 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
References of studies informing direct evidence:
7) Liang-2012
8) Litaker-2003
9) Askari-2018
10) Liang-2012
11) Liang-2012, Litaker-2003
12) Litaker-2003
13) Litaker-2003
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