Efficacy of lifestyle interventions in patients with type 2 diabetes: A systematic review and meta-analysis

Eur J Intern Med. 2016 Jan:27:37-47. doi: 10.1016/j.ejim.2015.11.016. Epub 2015 Dec 3.

Abstract

Background: The current meta-analysis evaluated the outcomes of various lifestyle interventions, including diet modifications (DIET), physical activity (PA), and patient education (EDU) in reducing the risk of cardiovascular disease in patients with type 2 diabetes.

Methods: Randomized clinical trials comparing lifestyle intervention with "usual care" (control) in type 2 diabetes patients were hand-searched from medical databases by two independent reviewers using the terms "diabetes, cardiovascular risk, lifestyle, health education, dietary, exercise/physical activities, and behavior intervention".

Results: Of the 235 studies identified, 17 were chosen for the meta-analysis. The average age of patients ranged from 50-67.3 years. Results reveal no significant difference between the groups, with respect to BMI, while PA and DIET yielded a greater reduction in HbA1c. Significant reduction in both systolic and diastolic pressures in the DIET group, and diastolic pressure in the PA group, was observed. HDL-c in the DIET group was significantly higher than the control group, while no change in LDL-c levels, was seen in all three intervention subtypes. There was no difference between the EDU vs. the control group in terms of HbA1c, blood pressure or HDL-c and LDL-c.

Conclusion: DIET intervention showed an improvement in HbA1c, systolic/diastolic blood pressure and HDL-c, with an exception of LDL-c and BMI, suggesting that nutritional intervention had a significant impact on the quality of life by reducing the cardiovascular risk in type 2 diabetes patients.

Keywords: Cardiovascular; Diabetes; Intervention; Lifestyle; Meta-analysis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Blood Pressure
  • Cardiovascular Diseases / epidemiology*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet*
  • Glycated Hemoglobin / analysis
  • Humans
  • Life Style*
  • Motor Activity*
  • Patient Education as Topic / methods*
  • Publication Bias
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Risk Factors

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human