PMID- 35273056
OWN - NLM
STAT- MEDLINE
DCOM- 20220427
LR  - 20221207
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 12
IP  - 3
DP  - 2022 Mar 10
TI  - Short-term effectiveness of nutrition therapy to treat type 2 diabetes in 
      low-income and middle-income countries: systematic review and meta-analysis of 
      randomised controlled trials.
PG  - e056108
LID - 10.1136/bmjopen-2021-056108 [doi]
LID - e056108
AB  - OBJECTIVES: This review examined the evidence arising from randomised controlled 
      trials regarding the impact of nutrition therapy on glycaemic control in people 
      living with type 2 diabetes mellitus (T2DM) in low/middle-income countries 
      (LMICs). DESIGN: Systematic review and meta-analysis using the Grading of 
      Recommendations, Assessment, Development and Evaluation (GRADE) Approach. DATA 
      SOURCES: MEDLINE, EMBASE, Web of Science, OpenGrey and the International Clinical 
      Trials Registry were searched (up to July 3 2020). ELIGIBILITY CRITERIA: Trials 
      were included if they evaluated nutrition therapy in adults diagnosed with T2DM, 
      were conducted in LMICs, measured glycaemic control and the trial included a 
      3-month post-intervention assessment. Nutrition therapy was defined according to 
      American Diabetes Association recommendations. DATA EXTRACTION AND SYNTHESIS: Two 
      independent reviewers screened the database. Study characteristics and outcome 
      data were extracted using a data collection form. Meta-analyses were conducted 
      for glycated haemoglobin (HbA1c) and fasting blood glucose. Trials were assessed 
      for risk of bias (Cochrane Risk-of-Bias, Version 2.0) and overall certainty of 
      evidence (GRADE). RESULTS: Four trials met inclusion criteria (total n=463), 
      conducted in Malaysia, Iran and South Africa. All trials focused on nutrition 
      education with no direct prescription or manipulation of diet. Mean differences 
      between intervention and standard care were -0.63% (95% CI -1.47% to 0.21%) for 
      HbA1c and -13.63 mg/dL (95% CI -37.61 to 10.34) for fasting blood glucose in 
      favour of the intervention. Given the small number of eligible trials, moderate 
      to high risk of publication bias and serious concerns regarding consistency and 
      precision of the evidence, certainty of evidence was deemed to be very low. 
      CONCLUSIONS: There is a lack of well-conducted randomised controlled trials that 
      examine the long-term impact of nutrition therapy in LMICs, preventing firm 
      conclusions to be made on their effectiveness. Further research is essential to 
      discover realistic, evidence-based solutions. PROSPERO REGISTRATION NUMBER: 
      CRD42020188435.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published 
      by BMJ.
FAU - Guilbert, Elizabeth
AU  - Guilbert E
AD  - Faculty of Health Sciences, University of Bristol, Bristol, UK.
FAU - Perry, Rachel
AU  - Perry R
AUID- ORCID: 0000-0001-5874-3016
AD  - National Institute for Health Research Bristol Biomedical Research Centre; 
      University Hospitals of Bristol and Weston NHS Foundation Trust and University of 
      Bristol, Bristol, UK.
FAU - Whitmarsh, Alex
AU  - Whitmarsh A
AD  - National Institute for Health Research Bristol Biomedical Research Centre; 
      University Hospitals of Bristol and Weston NHS Foundation Trust and University of 
      Bristol, Bristol, UK.
FAU - Sauchelli, Sarah
AU  - Sauchelli S
AUID- ORCID: 0000-0003-3620-7671
AD  - National Institute for Health Research Bristol Biomedical Research Centre; 
      University Hospitals of Bristol and Weston NHS Foundation Trust and University of 
      Bristol, Bristol, UK sarah.sauchellitoran@bristol.ac.uk.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220310
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Developing Countries
MH  - *Diabetes Mellitus, Type 2
MH  - Glycated Hemoglobin
MH  - Humans
MH  - *Nutrition Therapy
MH  - Randomized Controlled Trials as Topic
PMC - PMC8915303
OTO - NOTNLM
OT  - general diabetes
OT  - nutrition & dietetics
OT  - public health
COIS- Competing interests: None declared.
EDAT- 2022/03/12 06:00
MHDA- 2022/04/28 06:00
PMCR- 2022/03/10
CRDT- 2022/03/11 05:36
PHST- 2022/03/11 05:36 [entrez]
PHST- 2022/03/12 06:00 [pubmed]
PHST- 2022/04/28 06:00 [medline]
PHST- 2022/03/10 00:00 [pmc-release]
AID - bmjopen-2021-056108 [pii]
AID - 10.1136/bmjopen-2021-056108 [doi]
PST - epublish
SO  - BMJ Open. 2022 Mar 10;12(3):e056108. doi: 10.1136/bmjopen-2021-056108.