Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis

Anne Sophie Mathiesen,1 Ingrid Egerod,2 Tonny Jensen,1 Gudrun Kaldan,3 Henning Langberg,4 Thordis Thomsen3 1Department of Endocrinology, Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 2Intensive Care Unit 4131, Copenhagen University Hospital Rigshospitalet, Cop...

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Autores principales:	Mathiesen AS, Egerod I, Jensen T, Kaldan G, Langberg H, Thomsen T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Diabetes distress HbA1c Meta-analysis Psychosocial interventions Type 2 diabetes Vulnerable populations Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/1d2e8a841c9e466b9f26766a44517db8
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spelling	oai:doaj.org-article:1d2e8a841c9e466b9f26766a44517db82021-12-02T03:33:26ZPsychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis1178-7007https://doaj.org/article/1d2e8a841c9e466b9f26766a44517db82018-12-01T00:00:00Zhttps://www.dovepress.com/psychosocial-interventions-for-reducing-diabetes-distress-in-vulnerabl-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Anne Sophie Mathiesen,1 Ingrid Egerod,2 Tonny Jensen,1 Gudrun Kaldan,3 Henning Langberg,4 Thordis Thomsen3 1Department of Endocrinology, Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 2Intensive Care Unit 4131, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 3Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 4CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Abstract: Diabetes distress (DD) disproportionately affects vulnerable people with type 2 diabetes mellitus and interventions targeting this population are therefore relevant. A systematic review and meta-analysis was performed to assess the evidence for an effect of psychosocial interventions for reducing DD, and, secondly HbA1c, depression, and health-related quality of life in vulnerable people with type 2 diabetes mellitus. Vulnerability encompasses poor glycemic control (HbA1c >7.5%) and at least one additional risk factor for poor diabetes outcomes such as low educational level, comorbidity, and risky lifestyle behavior. The interventions should be theoretically founded and include cognition- or emotion-focused elements. We systematically searched four databases for articles published between January 1995 and March 2018. Eighteen studies testing a variety of psychosocial interventions in 4,066 patients were included. We adhered to the Cochrane methodology and PRISMA guidelines. Review Manager 5.3 was used for data extraction and risk of bias assessment, and Grades of Recommendation, Assessment, Development and Evaluation for assessing the quality of the evidence. Data were pooled using the fixed or random effects method as appropriate. We investigated effects of individual vs group, intensive vs brief interventions, and interventions with and without motivational interviewing in subgroup analyses. To assess the robustness of effect estimates, sensitivity analyses excluding studies with high risk of bias and attrition >20% were conducted. We found low to moderate quality evidence for a significant small effect of psychosocial interventions on DD, and very low to moderate quality evidence for no effect on HbA1c, both outcomes assessed at 3, 6, 12, and 24 months follow-up. The effect on depression was small, while there was no effect on health-related quality of life. Exploratory subgroup analyses suggested that interventions using motivational interviewing and individual interventions were associated with incremental effects on DD. Likewise, intensive interventions were associated with significant reductions in both DD and HbA1c. Keywords: diabetes distress, HbA1c, meta-analysis, psychosocial interventions, type 2 diabetes, vulnerable populationsMathiesen ASEgerod IJensen TKaldan GLangberg HThomsen TDove Medical PressarticleDiabetes distressHbA1cMeta-analysisPsychosocial interventionsType 2 diabetesVulnerable populationsSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 12, Pp 19-33 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diabetes distress HbA1c Meta-analysis Psychosocial interventions Type 2 diabetes Vulnerable populations Specialties of internal medicine RC581-951
spellingShingle	Diabetes distress HbA1c Meta-analysis Psychosocial interventions Type 2 diabetes Vulnerable populations Specialties of internal medicine RC581-951 Mathiesen AS Egerod I Jensen T Kaldan G Langberg H Thomsen T Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
description	Anne Sophie Mathiesen,1 Ingrid Egerod,2 Tonny Jensen,1 Gudrun Kaldan,3 Henning Langberg,4 Thordis Thomsen3 1Department of Endocrinology, Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 2Intensive Care Unit 4131, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 3Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 4CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Abstract: Diabetes distress (DD) disproportionately affects vulnerable people with type 2 diabetes mellitus and interventions targeting this population are therefore relevant. A systematic review and meta-analysis was performed to assess the evidence for an effect of psychosocial interventions for reducing DD, and, secondly HbA1c, depression, and health-related quality of life in vulnerable people with type 2 diabetes mellitus. Vulnerability encompasses poor glycemic control (HbA1c >7.5%) and at least one additional risk factor for poor diabetes outcomes such as low educational level, comorbidity, and risky lifestyle behavior. The interventions should be theoretically founded and include cognition- or emotion-focused elements. We systematically searched four databases for articles published between January 1995 and March 2018. Eighteen studies testing a variety of psychosocial interventions in 4,066 patients were included. We adhered to the Cochrane methodology and PRISMA guidelines. Review Manager 5.3 was used for data extraction and risk of bias assessment, and Grades of Recommendation, Assessment, Development and Evaluation for assessing the quality of the evidence. Data were pooled using the fixed or random effects method as appropriate. We investigated effects of individual vs group, intensive vs brief interventions, and interventions with and without motivational interviewing in subgroup analyses. To assess the robustness of effect estimates, sensitivity analyses excluding studies with high risk of bias and attrition >20% were conducted. We found low to moderate quality evidence for a significant small effect of psychosocial interventions on DD, and very low to moderate quality evidence for no effect on HbA1c, both outcomes assessed at 3, 6, 12, and 24 months follow-up. The effect on depression was small, while there was no effect on health-related quality of life. Exploratory subgroup analyses suggested that interventions using motivational interviewing and individual interventions were associated with incremental effects on DD. Likewise, intensive interventions were associated with significant reductions in both DD and HbA1c. Keywords: diabetes distress, HbA1c, meta-analysis, psychosocial interventions, type 2 diabetes, vulnerable populations
format	article
author	Mathiesen AS Egerod I Jensen T Kaldan G Langberg H Thomsen T
author_facet	Mathiesen AS Egerod I Jensen T Kaldan G Langberg H Thomsen T
author_sort	Mathiesen AS
title	Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
title_short	Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
title_full	Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
title_fullStr	Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
title_full_unstemmed	Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
title_sort	psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/1d2e8a841c9e466b9f26766a44517db8
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Psychosocial interventions for reducing diabetes distress in vulnerable people with type 2 diabetes mellitus: a systematic review and meta-analysis

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