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 |
1.8 [1.23, 2.38] |
Low |
It may result in a large increase in foot care self-management |
0 |
0 |
[, ] |
NA |
2.0 |
1.8 [1.23, 2.38] |
Low |
2. 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 |
-1.52 [-17.11, 14.06] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
0 |
0 |
[, ] |
NA |
1.0 |
-1.52 [-17.11, 14.06] |
Low |
3. 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 |
0.58 [-0.22, 1.37] |
Low |
It may result in a slight improvement in dietary habits |
0 |
0 |
[, ] |
N/A |
2.0 |
0.58 [-0.22, 1.37] |
Low |
4. 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 |
1.53 [-0.03, 3.09] |
Very low |
It may increase glucose self-monitoring but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
1.53 [-0.03, 3.09] |
Low |
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 |
-0.36 [-1.36, 0.64] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
-0.36 [-1.36, 0.64] |
Low |
6. 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 |
-0.12 [-0.59, 0.34] |
Very low |
It may result in little to no difference in physical activity |
1 |
280 |
-0.45 [-1.07, 0.16] |
Low |
2.0 |
0.33 [-0.39, 1.04] |
Low |
7. 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 |
-0.62 [-12.72, 11.48] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
1 |
36 |
10.0 [-16.15, 36.15] |
Moderate |
2.0 |
-3.52 [-17.17, 10.14] |
Moderate |
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 |
-2.25 [-7.0, 2.5] |
Moderate |
It may result in a large increase in HDL levels (mmol/L) |
1 |
36 |
-5.0 [-13.71, 3.71] |
Moderate |
2.0 |
-1.08 [-6.75, 4.59] |
Low |
9. 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 |
0.38 [-0.32, 1.07] |
Very Low |
It may result in little to no difference in quality of life but the evidence is very uncertain |
1 |
61 |
0.03 [-0.88, 0.94] |
Low |
2.0 |
0.86 [-0.21, 1.93] |
Low |
10. Dietary habits / Consumption of fat |
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 [-1.68, 1.12] |
Very low |
It may result in little to no difference in fat consumption |
1 |
190 |
-0.28 [-1.68, 1.12] |
Low |
0.0 |
NA [NA, NA] |
NA |
11. 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 |
0.04 [-0.58, 0.66] |
Low |
It may result in little to no difference in triglycerides (mmol/L) |
1 |
36 |
1.55 [-0.31, 3.41] |
Moderate |
2.0 |
-0.15 [-0.81, 0.5] |
Low |
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 |
2.05 [1.26, 2.85] |
Very low |
It may result in little to no difference in body mass index (kg/m²) but the evidence is very uncertain |
2 |
341 |
2.25 [1.37, 3.14] |
Very low |
2.0 |
1.25 [-0.52, 3.03] |
Very low |
13. 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 |
0.01 [-0.4, 0.42] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
2 |
316 |
0.32 [-0.22, 0.85] |
Very low |
2.0 |
-0.43 [-1.07, 0.22] |
Very low |
14. 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 |
0.0 [-0.95, 0.95] |
Very low |
It may result in little to no difference in self-efficacy |
1 |
280 |
0.0 [-0.95, 0.95] |
Low |
0.0 |
NA [NA, NA] |
NA |
15. 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 |
-3.75 [-12.25, 4.75] |
Very low |
It may result in little to no difference in weight (kgs) but the evidence is very uncertain |
1 |
36 |
-3.75 [-12.25, 4.75] |
Low |
0.0 |
NA [NA, NA] |
NA |
16. 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 |
3.0 [-2.59, 8.59] |
Very low |
It may increase diastolic blood pressure (mmHg) but the evidence is very uncertain |
1 |
36 |
3.0 [-2.59, 8.59] |
Low |
0.0 |
NA [NA, NA] |
NA |
17. 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 |
-1.0 [-11.47, 9.47] |
Very low |
It may increase systolic blood pressure levels (mmHg) but the evidence is very uncertain |
1 |
36 |
-1.0 [-11.47, 9.47] |
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: 2 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: 176 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 3) 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: 2 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 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: 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: 2 comparison(s). The range of follow up was from 2 to 24 months for the studies included in the whole network. 5) a) We rated down the certainty of evidence due to very serious imprecision; 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 2 to 24 months for the studies included in the whole network. 6) 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=142); 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 24 months in the studies directly comparing the self-management intervention versus usual care. 7) a) We rated down the certainty of evidence due to 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: 1 RCT(s) (N=18); 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 12 months in the studies directly comparing the self-management intervention versus usual care. 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=18); 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 12 months in the studies directly comparing the self-management intervention versus usual care. 9) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=31); Number of comparison(s) informing the indirect estimate: 2 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 10) a) Number of studies included in the network: 14 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=97); 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; b) We rated down the certainty of evidence due to very serious risk of bias very serious imprecision 11) a) Number of studies included in the network: 171 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=18); 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 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 12) 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: 231 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=173); 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 3-24 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 very serious inconsistency; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 2 RCT(s) (N=160); 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 12-24 months in the studies directly comparing the self-management intervention versus usual care. 14) 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: 55 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=142); 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 24 months in the studies directly comparing the self-management intervention versus usual care. 15) a) Number of studies included in the network: 145 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=18); 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 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 serious imprecision 16) a) Number of studies included in the network: 211 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=18); 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 very serious risk of bias and very serious imprecision 17) a) We rated down the certainty of evidence due to very 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: 1 RCT(s) (N=18); 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.
References of studies informing direct evidence:
6) Toobert-2011a 7) Gram-2010 8) Zapotoczky-2001 9) Huang-2016 10) Toobert-2011a 11) Zapotoczky-2001 12) Huang-2016, Toobert-2011a 13) Toobert-2011a, Zapotoczky-2001 14) Toobert-2011a 15) Zapotoczky-2001 16) Zapotoczky-2001 17) Zapotoczky-2001
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