1. 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 |
0.48 [-0.19, 1.16] |
Low |
It may result in little to no difference in dietary habits |
0 |
0 |
[, ] |
N/A |
3.0 |
0.48 [-0.19, 1.16] |
Low |
2. 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 |
-3.07 [-7.33, 1.19] |
Very low |
It may decrease diastolic blood pressure(mmHg) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
-3.07 [-7.33, 1.19] |
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 [-0.14, 2.56] |
Very low |
It may increase glucose self-monitoring but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
1.21 [-0.14, 2.56] |
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 |
-0.78 [-4.91, 3.35] |
Very low |
It may result in a large increase in HDL levels (mmol/L) |
0 |
0 |
[, ] |
NA |
3.0 |
-0.78 [-4.91, 3.35] |
Low |
5. 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 |
-2.19 [-4.37, -0.01] |
Low |
It may result in little to no difference in weight (kgs) |
0 |
0 |
[, ] |
NA |
2.0 |
-2.19 [-4.37, -0.01] |
Low |
6. 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 |
-0.18 [-1.18, 0.82] |
Very low |
It may result in little to no difference in psychological distress but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
2.0 |
-0.18 [-1.18, 0.82] |
Low |
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 |
0.03 [-0.48, 0.53] |
Very low |
It may result in little to no difference in physical activity |
0 |
0 |
[, ] |
NA |
3.0 |
0.03 [-0.48, 0.53] |
Low |
8. 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 |
-0.12 [-0.62, 0.39] |
Low |
It may result in little to no difference in triglycerides (mmol/L) |
0 |
0 |
[, ] |
NA |
4.0 |
-0.12 [-0.62, 0.39] |
Low |
9. 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 |
-5.15 [-17.88, 7.58] |
Very low |
It may result in little to no difference in systolic blood pressure levels (mmHg) but the evidence is very uncertain |
0 |
0 |
[, ] |
NA |
1.0 |
-5.15 [-17.88, 7.58] |
Very 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 |
1.84 [1.34, 2.33] |
Low |
It may result in a large increase in foot care self-management |
0 |
0 |
[, ] |
NA |
3.0 |
1.84 [1.34, 2.33] |
Low |
11. 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 |
0.29 [-1.87, 2.46] |
Very low |
It may result in little to no difference in self-management behaviours |
0 |
0 |
[, ] |
NA |
1.0 |
0.29 [-1.87, 2.46] |
Low |
12. 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 |
-1.53 [-15.01, 11.95] |
Low |
It may result in little to no difference in LDL levels (mg/dL) |
0 |
0 |
[, ] |
NA |
3.0 |
-1.53 [-15.01, 11.95] |
0 |
13. Physical activity / Steps/day |
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 |
0.79 [0.19, 1.39] |
Very low |
It may result in a slight increase in steps per day |
1 |
45 |
0.67 [0.03, 1.32] |
Low |
1.0 |
1.57 [-0.06, 3.2] |
Low |
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 |
0.23 [-0.64, 1.1] |
Very low |
It may result in little to no difference in knowledge but the evidence is very uncertain |
1 |
106 |
0.22 [-0.8, 1.24] |
Low |
2.0 |
0.25 [-1.46, 1.96] |
Low |
15. 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 |
0.64 [-0.11, 1.38] |
Very Low |
It may increase quality of life but the evidence is very uncertain |
1 |
30 |
1.22 [0.12, 2.31] |
Low |
2.0 |
0.13 [-0.89, 1.15] |
Low |
16. 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 |
0.25 [-1.57, 2.08] |
Very low |
It may result in little to no difference in care satisfaction but the evidence is very uncertain |
1 |
106 |
0.25 [-1.57, 2.08] |
Low |
0.0 |
NA [NA, NA] |
NA |
17. 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 |
-4.88 [-15.33, 5.56] |
Low |
It may result in little to no difference in total cholesterol (mg/dL) |
1 |
45 |
-0.4 [-24.26, 23.46] |
Low |
4.0 |
-5.95 [-17.57, 5.67] |
Low |
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 |
-0.63 [-1.68, 0.41] |
Low |
It may result in little to no difference in body mass index (kg/m²) |
1 |
45 |
-4.2 [-6.93, -1.47] |
Low |
4.0 |
-0.03 [-1.15, 1.1] |
Low |
19. 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 |
-10.97 [-16.11, -5.82] |
Very low |
It may decrease waist size (cm) but the evidence is very uncertain |
1 |
45 |
-11.8 [-17.89, -5.71] |
Low |
3.0 |
-8.89 [-18.5, 0.71] |
Low |
20. 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 |
-0.48 [-0.86, -0.11] |
Very low |
It may result in little to no difference in HbA1C levels (%) but the evidence is very uncertain |
1 |
45 |
0.01 [-0.85, 0.87] |
Low |
4.0 |
-0.6 [-1.02, -0.18] |
Low |
Footnotes per outcome:
1) 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: 3 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 2) 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: 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 and serious imprecision 3) 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. 4) a) We rated down the certainty of evidence due to serious riks of bias and serious imprecision; b) Number of studies included in the network: 162 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s) (N=0); 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. 5) a) Number of studies included in the network: 145 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 51 months for the studies included in the whole network; b) We rated down the certainty of evidence due to.. 6) 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. 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: 0 RCT(s) (N=0); 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. 8) a) 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: 4 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 serious risk of bias 9) a) We rated 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: 1 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. 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: 0 RCT(s) (N=0); Number of comparison(s) informing the indirect estimate: 3 comparison(s). The range of follow up was from 2 to 24 months for the studies included in the whole network. 11) a) Number of studies included in the network: 40 RCTs; Number of studies directly comparing the intervention with usual care: 0 RCT(s); Number of comparison(s) informing the indirect estimate: 1 comparison(s) The range of follow up was from 1 to 12 months for the studies included in the whole network ; b) We rated down the certainty of evidence due to very serious risk of bias 12) 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: 3 comparison(s). The range of follow up was from 1 to 96 months for the studies included in the whole network. 13) 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: 7 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=21); Number of comparison(s) informing the indirect estimate: 1 comparison(s). The range of follow up was from 3 to 12 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. 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=65); Number of comparison(s) informing the indirect estimate: 2 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 very serious imprecision 15) 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: 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 0 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 16) a) Number of studies included in the network: 13 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=65); 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 17) a) Number of studies included in the network: 176 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=21); 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 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 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: 1 RCT(s) (N=21); 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 months in the studies directly comparing the self-management intervention versus usual care. 19) a) Number of studies included in the network: 81 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=21); 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 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 20) a) We rated down the certainty of evidence due to serious imprecision, incoherence and very serious risk of bias; b) Number of studies included in the network: 463 RCTs; Number of studies directly comparing the intervention with usual care: 1 RCT(s) (N=21); 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 months in the studies directly comparing the self-management intervention versus usual care.
References of studies informing direct evidence:
13) De Greef-2011 14) Whitehead-2017 15) Noroozi-2017 16) Whitehead-2017 17) De Greef-2011 18) De Greef-2011 19) De Greef-2011 20) De Greef-2011
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