Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
Syst Rev. 2021 Mar 20;10(1):81. doi: 10.1186/s13643-021-01619-3.
Our objective was to estimate the change in community-based education interventions throughout the world that may effectuate in risk parameters of type II diabetes (T2D), including the diabetes incidence rate, fasting blood glucose, hemoglobin A1C, body mass index, waist circumference, and systolic and diastolic blood pressure.
A comprehensive search for globally eligible studies was conducted on PubMed, Embase, ProQuest, CINAHL nursing & allied health source, Cochrane Library, Google Scholar, conference proceedings, and reference lists. Data were extracted using JBI standardized data extraction tool. The primary outcome variables were diabetes incidence rate, fasting blood sugar (FBS), hemoglobin A1c (HbAlc), body mass index (BMI), waist circumference (WC), systolic/diastolic blood pressure (s/d BP). Random-effects meta-analysis and sub-group analyses were conducted.
Nineteen interventional studies were included in the review, and ten studies were pooled in the meta-analysis (n = 16,106, mean age = 41.5 years). The incidence rate of T2D was reported in three trials, within which the risk of developing T2D was reduced by 54.0% in favor of community-based educational interventions, (RR = 0.54, 95% CI = 0.38-0.75; p < 0.001). In eleven (n = 11,587) and six (n = 6416) studies, the pooled mean differences were - 0.33 (95% CI: - 0.45 to - 0.20, p < 0.0001) and - 0.15 (95% CI: - 0.28 to - 0.03, p < 0.0001) for FBS and HbA1c levels, respectively. Positive significant effects were observed on reducing BMI [pooled mean difference = - 0.47 (95% CI: - 0.66 to - 0.28), I = 95.7%, p < 0.0001] and WC [pooled mean difference = - 0.66 (95% CI: - 0.89 to - 0.43), I = 97.3%, p < 0.0001]. The use of theoretical frameworks was found to provide a 48.0% change in fasting blood sugar.
Based on a comprehensive data collection of about 16,106 participants and reasonable analyses, we conclude that educational interventions may reduce diabetes incidence by 54.0%, particularly through reductions in fasting blood glucose, body mass index, and waist circumference. The diabetes risk parameters may favorably improve irrespective of the duration of intervention, at as low as 6 months. The application of theoretical frameworks while designing educational interventions is also encouraged.
PROSPERO CRD42018115877.
我们的目的是估计全球范围内以社区为基础的教育干预措施的变化，这些变化可能会影响到 II 型糖尿病（T2D）的风险参数，包括糖尿病发病率、空腹血糖、糖化血红蛋白（HbAlc）、体重指数、腰围、收缩压和舒张压。
在 PubMed、Embase、ProQuest、CINAHL 护理与联合健康资源、Cochrane 图书馆、Google Scholar、会议记录和参考文献列表上进行了全面的全球合格研究检索。使用 JBI 标准化数据提取工具提取数据。主要结局变量是糖尿病发病率、空腹血糖（FBS）、糖化血红蛋白（HbAlc）、体重指数（BMI）、腰围（WC）、收缩压/舒张压（s/d BP）。进行了随机效应荟萃分析和亚组分析。
综述纳入了 19 项干预研究，其中 10 项研究进行了荟萃分析（n = 16106，平均年龄 = 41.5 岁）。三项试验报告了 T2D 的发病率，其中社区教育干预可使 T2D 的发病风险降低 54.0%，这是有利的（RR = 0.54，95%CI = 0.38-0.75；p < 0.001）。在 11 项（n = 11587）和 6 项（n = 6416）研究中，FBS 和 HbA1c 水平的汇总平均差异分别为 - 0.33（95%CI：- 0.45 至- 0.20，p < 0.0001）和 - 0.15（95%CI：- 0.28 至- 0.03，p < 0.0001）。观察到 BMI [汇总平均差异 = - 0.47（95%CI：- 0.66 至- 0.28），I = 95.7%，p < 0.0001]和 WC [汇总平均差异 = - 0.66（95%CI：- 0.89 至- 0.43），I = 97.3%，p < 0.0001]的降低有显著的积极影响。发现使用理论框架可使空腹血糖降低 48.0%。
基于对约 16106 名参与者的全面数据收集和合理分析，我们得出结论，教育干预措施可能降低 54.0%的糖尿病发病率，特别是通过降低空腹血糖、体重指数和腰围。无论干预持续时间如何，糖尿病风险参数都可能得到有利改善，最低仅需 6 个月。在设计教育干预措施时，还鼓励应用理论框架。
PROSPERO CRD42018115877。
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