PMID- 35667728
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20221207
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 12
IP  - 6
DP  - 2022 Jun 6
TI  - Non-pharmacological interventions for the prevention of type 2 diabetes in 
      low-income and middle-income countries: a systematic review of randomised 
      controlled trials.
PG  - e062671
LID - 10.1136/bmjopen-2022-062671 [doi]
LID - e062671
AB  - OBJECTIVE: Diabetes poses serious health threats and economic burdens to 
      patients, especially in low-income and middle-income countries (LMICs). This 
      systematic review searches for non-pharmacological interventions for the 
      prevention of type-2 diabetes mellitus (T2DM) among patients who are non-diabetic 
      and pre-diabetic from LMICs. SETTINGS: LMICs. PARTICIPANTS: Adult population aged 
      over 18 years without having diabetes. PRIMARY AND SECONDARY OUTCOMES: Primary 
      outcome is to measure the change in the incidence of T2DM. The secondary outcome 
      is to measure changes in glycated haemoglobin (HbA1c) level, weight/body mass 
      index (BMI), fasting glucose level and 2-hour glucose from baseline of the 
      included randomised controlled trials. METHODS: This review has been conducted 
      following the standard systematic review guidelines. A total of six electronic 
      databases including MEDLINE, Embase, the Cochrane Library, Web of Science, 
      ClinicalTrials.gov and International Clinical Trials Registry Platform were 
      searched in February 2021 using a comprehensive search strategy.Two sets of 
      independent reviewers performed screening, risk of bias (ROB) assessment using 
      the Cochrane ROB tool and data extraction. Narrative coalescence of selected 
      articles was demonstrated using tables. No meta-analysis was performed due to the 
      lack of homogenous intervention strategies and study settings. RESULT: A total of 
      five studies were included for the review with a combined population of 1734 from 
      three countries. Three of the studies showed a significant reduction in T2DM 
      incidence after the intervention of physical training and dietary modifications. 
      Four of the studies also demonstrated a significant reduction of different 
      secondary outcomes like weight, BMI, fasting and 2-hour plasma glucose and HbA1c. 
      All the studies demonstrated a low ROB in most of the bias assessment domains 
      with some unclear results in allocation concealments. CONCLUSIONS: Emphasising 
      non-pharmacological interventions for T2DM prevention can improve health outcomes 
      and lessen the economic burdens, which will be of paramount importance in LMICs. 
      SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42020191507.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Sarker, Anupam
AU  - Sarker A
AD  - Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh.
AD  - Department of Computer Science, Georgia State University, Atlanta, Georgia, USA.
FAU - Das, Rina
AU  - Das R
AUID- ORCID: 0000-0001-7499-7278
AD  - Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.
FAU - Ether, Saraban
AU  - Ether S
AD  - Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh.
FAU - Shariful Islam, Md
AU  - Shariful Islam M
AUID- ORCID: 0000-0002-3015-0830
AD  - Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
FAU - Saif-Ur-Rahman, K M
AU  - Saif-Ur-Rahman KM
AUID- ORCID: 0000-0001-8702-7094
AD  - Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh 
      su.rahman@icddrb.org.
AD  - College of Medicine, Nursing and Health Sciences, National University of Ireland, 
      Galway, Ireland.
AD  - Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20220606
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Glycated Hemoglobin A)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Adult
MH  - Developing Countries
MH  - *Diabetes Mellitus, Type 2/prevention & control
MH  - Glucose
MH  - Glycated Hemoglobin
MH  - Humans
MH  - Middle Aged
MH  - *Prediabetic State/complications
PMC - PMC9171210
OTO - NOTNLM
OT  - epidemiology
OT  - general diabetes
OT  - preventive medicine
OT  - public health
COIS- Competing interests: None declared.
EDAT- 2022/06/07 06:00
MHDA- 2022/06/09 06:00
PMCR- 2022/06/06
CRDT- 2022/06/06 20:53
PHST- 2022/06/06 20:53 [entrez]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2022/06/06 00:00 [pmc-release]
AID - bmjopen-2022-062671 [pii]
AID - 10.1136/bmjopen-2022-062671 [doi]
PST - epublish
SO  - BMJ Open. 2022 Jun 6;12(6):e062671. doi: 10.1136/bmjopen-2022-062671.