Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: a systematic review and meta-analysis

Terranova, C. O., Brakenridge, C. L., Lawler, S. P., Eakin, E. G. and Reeves, M. M. (2015) Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes, Obesity and Metabolism, 17 4: 371-378. doi:10.1111/dom.12430

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Author Terranova, C. O.
Brakenridge, C. L.
Lawler, S. P.
Eakin, E. G.
Reeves, M. M.
Title Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: a systematic review and meta-analysis
Journal name Diabetes, Obesity and Metabolism   Check publisher's open access policy
ISSN 1462-8902
1463-1326
Publication date 2015-04-01
Sub-type Article (original research)
DOI 10.1111/dom.12430
Volume 17
Issue 4
Start page 371
End page 378
Total pages 8
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Collection year 2016
Language eng
Formatted abstract
Aims: To provide a systematic review and meta-analysis of recent evidence on the effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes.

Methods: A search of the literature from January 2003 to July 2013 was conducted (PubMed, Embase, CINAHL and Web of Science). The studies considered eligible were randomized controlled trials evaluating weight loss interventions (diet and physical activity, with or without behavioural strategies) of ≥12 weeks duration, compared with usual care or another comparison intervention. Ten studies were included for review. Some heterogeneity was present in the sample, therefore, random-effects models were used to calculate pooled effects.

Results: Intervention duration ranged from 16 weeks to 9 years, with all but one delivered via individual or group face-to-face sessions. From six studies comparing lifestyle intervention with usual care the pooled effect on weight (n = 5795) was −3.33 kg [95% confidence interval (CI) −5.06, −1.60 kg], and on glycated haemoglobin (HbA1c; n = 5784) was −0.29% (95% CI −0.61, 0.03%), with both attenuated in sensitivity analyses. The pooled within-group effect on weight (n = 3063) from all 10 lifestyle intervention groups was −5.33 kg (95% CI −7.33, −3.34 kg), also attenuated in sensitivity analyses. None of the participant or intervention characteristics examined explained the heterogeneity. Only one study assessed whether intervention effects were maintained after the end of the intervention.

Conclusions: Lifestyle-based weight loss intervention trials in type 2 diabetes achieve, on average, modest reductions in weight and HbA1c levels, but results were heavily influenced by one trial. Evidence-based approaches for improving the effectiveness of lifestyle-based interventions in type 2 diabetes are needed, along with future studies reporting on maintenance and cost-effectiveness.
Keyword Glycaemic control
Meta-analysis
Systematic review
Type 2 diabetes
Weight loss programs
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 6 times in Thomson Reuters Web of Science Article | Citations
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Created: Sat, 21 Feb 2015, 20:45:11 EST by Caroline Terranova on behalf of School of Public Health