Interventions to reduce diabetes-related distress among adults with type 1 or type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
Authors' conclusion
Psychological interventions reduced diabetes distress among adults with type 1 diabetes and those with type 2 diabetes, while devices reduced diabetes distress in adults with type 1 diabetes and education reduced diabetes distress in adults with type 2 diabetes. Most other interventions showed little or no clear effect.
Study context
- Population
- Adults (≥18 years) with T1D or T2D in RCTs recording diabetes distress
- Participants
- 55,497 adults248 trials
- Comparison
- Interventions vs usual care or active control
- Psychological interventionsn = 59 trials
- Psychoeducational interventionsn = 68 trials
- Miscellaneous interventionsn = 121 trials
- Outcome
- Diabetes distress measured with a validated questionnaire (SMD)
Methodological detailsrandom-effects meta-analysis, GRADE certainty assessment, Cochrane RoB2 risk of bias, Searched PubMed, Cochrane Library, APA PsycInfo and CINAHL to 23 September 2024, No meta-analyses for telehealth, health behaviours and mixed interventions due to heterogeneity or insufficient studies
- Random-effects meta-analysis
- GRADE certainty assessment
- Cochrane RoB2 risk of bias
- Searched PubMed, Cochrane Library, APA PsycInfo and CINAHL to 23 September 2024
- No meta-analyses for telehealth, health behaviours and mixed interventions due to heterogeneity or insufficient studies
Pooled result
As reported in the abstract
Further pooled results
Other comparisons (psychological, psychoeducational, peer support, educational and device-based interventions vs active controls or usual care)
- Other comparisons did not show statistically significant effects
Certainty of evidence (GRADE)
- Comparisons with moderate certainty
- two
- Comparisons with low certainty
- five
- Comparisons with very low certainty
- seven
Predefined subgroups (baseline distress, delivery method, risk of bias, trial duration)
- Results did not differ meaningfully across predefined subgroups
Telehealth, health behaviours and assorted mixed interventions
- No meta-analyses could be conducted due to heterogeneity or an insufficient number of studies
Original publication
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