PMID- 34893413
OWN - NLM
STAT- MEDLINE
DCOM- 20220310
LR  - 20221207
IS  - 1590-3729 (Electronic)
IS  - 0939-4753 (Linking)
VI  - 32
IP  - 2
DP  - 2022 Feb
TI  - Self-management in patients with type 2 diabetes: Group-based versus individual 
      education. A systematic review with meta-analysis of randomized trails.
PG  - 330-336
LID - S0939-4753(21)00501-9 [pii]
LID - 10.1016/j.numecd.2021.10.005 [doi]
AB  - AIM: Patient education is an essential component of the treatment of type 2 
      diabetes mellitus (T2DM). The present meta-analysis was aimed at verifying the 
      efficacy of group-based versus individual education for self-management in 
      patients with T2DM. DATA SYNTHESIS: A Medline and Embase search up to January 
      1st, 2021, was performed, including Randomized Controlled Trials (RCT) with 
      duration>6 months, enrolling patients with T2DM and comparing individual-based 
      with group-based educational programs. The primary outcome was endpoint HbA1c; 
      secondary endpoints were lipid profile, body weight, blood pressure, patients' 
      adherence/knowledge, and quality of life. The weighed difference in means (WMD) 
      and Mantel-Haenzel Odds Ratio (MH-OR), with 95% Confidence Interval (CI), were 
      calculated. We retrieved 14 RCT. No significant between-group difference in HbA1c 
      (WMD -0.39[-0.89; 0.09] mmol/mol, p = 0.11) was observed. At metaregression 
      analyses, longer trial duration, higher baseline mean age and duration of 
      diabetes, and lower baseline HbA1c were correlated with greater efficacy of 
      group-based programs in reducing HbA1c. When analyzed separately, trials 
      excluding insulin-treated patients showed a significant reduction of HbA1c in 
      favor of group education. CONCLUSIONS: In patients with T2DM, group education has 
      similar efficacy as individual education on glucose control. Group programs are 
      associated with an improved quality of life and patients' knowledge. PROSPERO AND 
      OSF REGISTRATION: ID243149.
CI  - Copyright (c) 2021 The Italian Diabetes Society, the Italian Society for the Study 
      of Atherosclerosis, the Italian Society of Human Nutrition and the Department of 
      Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. 
      All rights reserved.
FAU - Mannucci, Edoardo
AU  - Mannucci E
AD  - Diabetology, Careggi Hospital, Florence, Italy; University of Florence, Italy.
FAU - Giaccari, Andrea
AU  - Giaccari A
AD  - Centro per le Malattie Endocrine e Metaboliche, Fondazione Policlinico 
      Universitario A. Gemelli UCSC and Universita Cattolica Del Sacro Cuore, Rome, 
      Italy.
FAU - Gallo, Marco
AU  - Gallo M
AD  - Endocrinology and Metabolic Diseases Unit, AO SS. Antonio e Biagio e Cesare 
      Arrigo, Alessandria, Italy.
FAU - Bonifazi, Allegra
AU  - Bonifazi A
AD  - University of Florence, Italy.
FAU - Belen, Avila D P
AU  - Belen ADP
AD  - University of Florence, Italy.
FAU - Masini, Maria L
AU  - Masini ML
AD  - Scuola Di Scienze Della Salute Umana, University of Florence, Italy.
FAU - Trento, Marina
AU  - Trento M
AD  - Laboratory of Clinical Pedagogy, Department Medical Sciences, University of 
      Turin, Italy.
FAU - Monami, Matteo
AU  - Monami M
AD  - Diabetology, Careggi Hospital, Florence, Italy. Electronic address: 
      matteo.monami@unifi.it.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20211014
PL  - Netherlands
TA  - Nutr Metab Cardiovasc Dis
JT  - Nutrition, metabolism, and cardiovascular diseases : NMCD
JID - 9111474
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Insulin)
SB  - IM
MH  - Blood Glucose
MH  - *Diabetes Mellitus, Type 2/diagnosis/drug therapy
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Insulin
MH  - *Self-Management
OTO - NOTNLM
OT  - Body weight
OT  - Educational programs
OT  - Glycemic control
OT  - Lipid profile
OT  - Quality of life
OT  - Type 2 diabetes
COIS- Declaration of competing interest EM has received consultancy fees from Merck and 
      Novartis speaking fees from Astra Zeneca, Bristol Myers Squibb, 
      Boehringer-Ingelheim, Eli-Lilly, Merck, Novo Nordisk, Sanofi, and Novartis, and 
      research grants from Merck, Novartis, and Takeda. MM has received speaking fees 
      from Astra Zeneca, Bristol Myers Squibb, Boehringer-Ingelheim, Eli-Lilly, Merck, 
      Novo Nordisk, Sanofi, and Novartis and research grants from Bristol Myers Squibb; 
      AB, BDA, MG, MLM, MT and AG have no relevant conflicts of interest to declare. 
      All the authors approved the final version of this manuscript. Dr. Edoardo 
      Mannucci is the person who takes full responsibility for the work as a whole, 
      including the study design, access to data, and the decision to submit and 
      publish the manuscript.
EDAT- 2021/12/12 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/12/11 05:33
PHST- 2021/04/30 00:00 [received]
PHST- 2021/09/21 00:00 [revised]
PHST- 2021/10/03 00:00 [accepted]
PHST- 2021/12/12 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/12/11 05:33 [entrez]
AID - S0939-4753(21)00501-9 [pii]
AID - 10.1016/j.numecd.2021.10.005 [doi]
PST - ppublish
SO  - Nutr Metab Cardiovasc Dis. 2022 Feb;32(2):330-336. doi: 
      10.1016/j.numecd.2021.10.005. Epub 2021 Oct 14.