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Psychological interventions to improve glycaemic control in type 1 and type 2 diabetes: A systematic review and meta-analysis

We conducted a systematic review and meta-analysis of psychological interventions in type 1 diabetes and type 2 diabetes to assess whether their effectiveness in improving glycaemic levels has improved over the past 30 years. We applied the protocol of a systematic review and aggregate meta-analysis conducted to January 2003. We added network meta-analysis (NMA) to compare intervention and control group type against usual care. MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, EMBASE, Cochrane Controlled Trials Database, Web of Science, and Dissertation Abstracts International were searched from January 2003 to July 2018. Only randomized controlled trials (RCT) of psychological interventions for adults with T2D reported in any language were included. The primary outcome was change in glycaemic control (glycated hemoglobin (HbA1c) in mmol/mol). Data were extracted from study reports and authors were contacted for missing data.

We conducted an aggregate meta-analysis for adults with type 1 diabetes (9 RCTs, n = 1102) and children/adolescents with type 1 diabetes (20 RCTs, n = 2567). Overall psychological interventions for children and adults with type 1 diabetes do not improve glycaemic control. For adults, CBT-based interventions have the potential to be effective.

In 70 RCTs (n=14 796 participants), the effectiveness of psychological interventions for adults with type 2 diabetes had minimal clinical benefit in improving glycaemic control.

Publications

Psychological interventions to improve glycemic control in adults with type 2 diabetes: A systematic review and meta-analysis

Systematic review and meta‐analysis of randomized controlled trials of psychological interventions to improve glycaemic control in children and adults with type 1 diabetes