The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.

<h4>Background</h4>Behavioral interventions targeted at managing Type 2 diabetes mellitus (T2DM) may have a positive effect on quality of life (QOL). Limited reviews have synthesized this effect in low- and middle-income countries (LMICs). This review and meta-analysis synthesised availa...

Full description

Bibliographic Details
Main Authors: Ashmita Karki, Corneel Vandelanotte, Saman Khalesi, Padam Dahal, Lal B Rawal
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293028&type=printable
_version_ 1827783583134121984
author Ashmita Karki
Corneel Vandelanotte
Saman Khalesi
Padam Dahal
Lal B Rawal
author_facet Ashmita Karki
Corneel Vandelanotte
Saman Khalesi
Padam Dahal
Lal B Rawal
author_sort Ashmita Karki
collection DOAJ
description <h4>Background</h4>Behavioral interventions targeted at managing Type 2 diabetes mellitus (T2DM) may have a positive effect on quality of life (QOL). Limited reviews have synthesized this effect in low- and middle-income countries (LMICs). This review and meta-analysis synthesised available evidence on the effect of behavioral interventions to manage T2DM on the QOL of people with T2DM in LMICs.<h4>Methods</h4>Electronic databases PUBMED/MEDLINE, SCOPUS, CINAHL, Embase, Web of Science and PsycINFO were searched from May to June 2022. Studies published between January 2000 and May 2022, conducted in LMICs using randomized controlled trial design, using a health behavior intervention for T2DM management, and reporting QOL outcomes were included. Difference in QOL change scores between the intervention and control group was calculated as the standardized mean difference (SMD) of QOL scores observed between the intervention and control groups. Random-effects model was used for meta-analysis.<h4>Results</h4>Of 6122 studies identified initially, 45 studies met the inclusion criteria (n = 8336). Of them, 31 involved diabetes self-management education and 14 included dietary and/or physical activity intervention. There was moderate quality evidence from the meta-analysis of mean QOL (n = 25) that health behavior intervention improved the QOL of people with T2DM (SMD = 1.62, 95%CI = 0.65-2.60 I2 = 0.96, p = 0.001). However, no significant improvements were found for studies (n = 7) separately assessing the physical component summary (SMD = 0.76, 95%CI = -0.03-1.56 I2 = 0.94, p = 0.060) and mental component summary (SMD = 0.43, 95%CI = -0.30-1.16 I2 = 0.94, p = 0.249) scores. High heterogeneity and imprecise results across studies resulted in low to moderate quality of evidence.<h4>Conclusion</h4>The findings suggest that health behavior interventions to manage T2DM may substantially improve the QOL of individuals with T2DM over short term. However, due to low to moderate quality of evidence, further research is required to corroborate our findings. Results of this review may guide future research and have policy implications for T2DM management in LMICs.
first_indexed 2024-03-11T15:49:29Z
format Article
id doaj.art-eb41be49cf094e848b5d7727d6da096f
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-03-11T15:49:29Z
publishDate 2023-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-eb41be49cf094e848b5d7727d6da096f2023-10-26T05:31:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011810e029302810.1371/journal.pone.0293028The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.Ashmita KarkiCorneel VandelanotteSaman KhalesiPadam DahalLal B Rawal<h4>Background</h4>Behavioral interventions targeted at managing Type 2 diabetes mellitus (T2DM) may have a positive effect on quality of life (QOL). Limited reviews have synthesized this effect in low- and middle-income countries (LMICs). This review and meta-analysis synthesised available evidence on the effect of behavioral interventions to manage T2DM on the QOL of people with T2DM in LMICs.<h4>Methods</h4>Electronic databases PUBMED/MEDLINE, SCOPUS, CINAHL, Embase, Web of Science and PsycINFO were searched from May to June 2022. Studies published between January 2000 and May 2022, conducted in LMICs using randomized controlled trial design, using a health behavior intervention for T2DM management, and reporting QOL outcomes were included. Difference in QOL change scores between the intervention and control group was calculated as the standardized mean difference (SMD) of QOL scores observed between the intervention and control groups. Random-effects model was used for meta-analysis.<h4>Results</h4>Of 6122 studies identified initially, 45 studies met the inclusion criteria (n = 8336). Of them, 31 involved diabetes self-management education and 14 included dietary and/or physical activity intervention. There was moderate quality evidence from the meta-analysis of mean QOL (n = 25) that health behavior intervention improved the QOL of people with T2DM (SMD = 1.62, 95%CI = 0.65-2.60 I2 = 0.96, p = 0.001). However, no significant improvements were found for studies (n = 7) separately assessing the physical component summary (SMD = 0.76, 95%CI = -0.03-1.56 I2 = 0.94, p = 0.060) and mental component summary (SMD = 0.43, 95%CI = -0.30-1.16 I2 = 0.94, p = 0.249) scores. High heterogeneity and imprecise results across studies resulted in low to moderate quality of evidence.<h4>Conclusion</h4>The findings suggest that health behavior interventions to manage T2DM may substantially improve the QOL of individuals with T2DM over short term. However, due to low to moderate quality of evidence, further research is required to corroborate our findings. Results of this review may guide future research and have policy implications for T2DM management in LMICs.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293028&type=printable
spellingShingle Ashmita Karki
Corneel Vandelanotte
Saman Khalesi
Padam Dahal
Lal B Rawal
The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.
PLoS ONE
title The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.
title_full The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.
title_fullStr The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.
title_full_unstemmed The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.
title_short The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis.
title_sort effect of health behavior interventions to manage type 2 diabetes on the quality of life in low and middle income countries a systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293028&type=printable
work_keys_str_mv AT ashmitakarki theeffectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT corneelvandelanotte theeffectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT samankhalesi theeffectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT padamdahal theeffectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT lalbrawal theeffectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT ashmitakarki effectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT corneelvandelanotte effectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT samankhalesi effectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT padamdahal effectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis
AT lalbrawal effectofhealthbehaviorinterventionstomanagetype2diabetesonthequalityoflifeinlowandmiddleincomecountriesasystematicreviewandmetaanalysis