Pub Date : 2025-02-08DOI: 10.1016/j.pcd.2025.01.006
Khadija A. Matrook , David L. Whitford , Susan M. Smith , Sinead McGilloway , Mapa Prabhath Piyasena , Seamus Cowman
Family-based interventions involve family members in caring for patients with diabetes, but it is unclear whether they are effective in improving outcomes for type 2 diabetes (T2DM). This systematic review and meta-analysis aim to determine the effectiveness of family-based interventions in improving glycaemic control in T2DM patients. We identified 6163 abstracts. Eleven RCTs (n = 1421) met our inclusion criteria. The overall findings suggest that family-based interventions are effective in improving HbA1c, at 3–4 months follow-up and when the intervention is delivered by nurses, with modest effects. Consideration should be given to integrating family-based interventions in the primary care among cultures with greater family cohesion.
{"title":"Family-based interventions for adults with type 2 diabetes mellitus: A systematic review and meta-analysis","authors":"Khadija A. Matrook , David L. Whitford , Susan M. Smith , Sinead McGilloway , Mapa Prabhath Piyasena , Seamus Cowman","doi":"10.1016/j.pcd.2025.01.006","DOIUrl":"10.1016/j.pcd.2025.01.006","url":null,"abstract":"<div><div>Family-based interventions involve family members in caring for patients with diabetes, but it is unclear whether they are effective in improving outcomes for type 2 diabetes (T2DM). This systematic review and meta-analysis aim to determine the effectiveness of family-based interventions in improving glycaemic control in T2DM patients. We identified 6163 abstracts. Eleven RCTs (n = 1421) met our inclusion criteria. The overall findings suggest that family-based interventions are effective in improving HbA1c, at 3–4 months follow-up and when the intervention is delivered by nurses, with modest effects. Consideration should be given to integrating family-based interventions in the primary care among cultures with greater family cohesion.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 111-119"},"PeriodicalIF":2.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.pcd.2025.01.008
A.K. Woolley , A. Sumner , M. Gupta , H. Sathanapally , D. Bodicoat , K. Khunti , S. Seidu
Background
Health education is integral to cardiometabolic disease (CMD) management. Certain populations, such as people with lower educational attainment have higher risk of CMD and worse outcomes. They are also known to have differing preferences for health education formats and delivery compared with the general population. This study assessed the efficacy of CMD educational interventions in populations with lower educational attainment.
Methods
Four databases (Medline, Proquest, CINAHL, and Google Scholar) were systematically searched to identify studies using an educational intervention, targeting CMD-related outcomes, in a population with low educational attainment, in a community or primary care setting. A random-effects meta-analysis was conducted to calculate pooled mean differences.
Results
Educational interventions were associated with statistically significant improvements at approximately 3 months, compared with baseline, in terms of BMI (mean difference [95 % confidence interval] = −0.27 [-0.42, −0.12] kg/m2; p < 0.001), weight (-0.20 [-0.35, −0.06] kg; p = 0.007), % fat in diet (-2.45 [-3.08, −1.81]; p < 0.001), systolic blood pressure (-0.51 [-0.98, −0.05] mmHg; p = 0.031), total cholesterol (-0.54 [-0.70, −0.38] mg/dL; p < 0.001), HbA1c (-0.46 [-0.74, −0.17] %; p = 0.002), physical activity (1.04 [0.43, 1.66] hours/week; p < 0.001), and CES depression score (-0.72 [-1.16, −0.27]; 0.002). However, where 12 or 24 month follow-up data were available, there were no statistically significant differences compared with baseline.
Conclusion
CMD education interventions can improve multiple outcomes in the short term in people with lower educational attainment. Further work is needed around how such benefits may be maintained.
{"title":"Effectiveness of cardiometabolic health education interventions in populations with lower educational attainment: A systematic review and meta-analysis","authors":"A.K. Woolley , A. Sumner , M. Gupta , H. Sathanapally , D. Bodicoat , K. Khunti , S. Seidu","doi":"10.1016/j.pcd.2025.01.008","DOIUrl":"10.1016/j.pcd.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Health education is integral to cardiometabolic disease (CMD) management. Certain populations, such as people with lower educational attainment have higher risk of CMD and worse outcomes. They are also known to have differing preferences for health education formats and delivery compared with the general population. This study assessed the efficacy of CMD educational interventions in populations with lower educational attainment.</div></div><div><h3>Methods</h3><div>Four databases (Medline, Proquest, CINAHL, and Google Scholar) were systematically searched to identify studies using an educational intervention, targeting CMD-related outcomes, in a population with low educational attainment, in a community or primary care setting. A random-effects meta-analysis was conducted to calculate pooled mean differences.</div></div><div><h3>Results</h3><div>Educational interventions were associated with statistically significant improvements at approximately 3 months, compared with baseline, in terms of BMI (mean difference [95 % confidence interval] = −0.27 [-0.42, −0.12] kg/m<sup>2</sup>; p < 0.001), weight (-0.20 [-0.35, −0.06] kg; p = 0.007), % fat in diet (-2.45 [-3.08, −1.81]; p < 0.001), systolic blood pressure (-0.51 [-0.98, −0.05] mmHg; p = 0.031), total cholesterol (-0.54 [-0.70, −0.38] mg/dL; p < 0.001), HbA1c (-0.46 [-0.74, −0.17] %; p = 0.002), physical activity (1.04 [0.43, 1.66] hours/week; p < 0.001), and CES depression score (-0.72 [-1.16, −0.27]; 0.002). However, where 12 or 24 month follow-up data were available, there were no statistically significant differences compared with baseline.</div></div><div><h3>Conclusion</h3><div>CMD education interventions can improve multiple outcomes in the short term in people with lower educational attainment. Further work is needed around how such benefits may be maintained.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 120-132"},"PeriodicalIF":2.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed determine the prevalence of shoulder pain among Chilean patients with type 2 DM and to characterize their pain intensity and associated disabilities, including an analysis of sex-based differences.
Methods
A total of 151 participants with type 2 DM, aged 18–79, from family health centers in Talca, Chile, were included. Data were collected via telephone interview, capturing demographic details and information about current shoulder pain, including its duration, intensity, using a Numerical Rating Scale (NRS), and disability using the Shoulder Pain and Disability Index (SPADI). Statistical analysis was performed using frequency measures, Chi-squared tests, binary logistic regression, and Student's t-tests with SPSS version 21.0.
Results
Out of 1662 eligible patients, 151 participated. The overall prevalence of shoulder pain was 53.6 % (95 % CI: 53.8–53.4), with women showing a higher prevalence (63 %; 95 % CI: 63.2–62.8) compared to men (37 %; 95 % CI: 37.2–36.8), a difference that was statistically significant (chi-square=13.5; p ≤ 0.001). The results showed that neither BMI nor sex was significantly associated with the presence of pain. No significant differences were found between sexes regarding pain intensity and disability (p ≥ 0.05).
Conclusion
Shoulder pain is highly prevalent among patients with type 2 DM, with a higher prevalence in women. Future research should explore the impact of this condition on patients and develop targeted musculoskeletal rehabilitation programs.
{"title":"Shoulder pain among type 2 diabetes mellitus patients: A cross-sectional study in Chilean population","authors":"Fernanda A.P. Habechian , Mauricio Esteban Flores-Quezada , Anais Catalina Martinez-Ortega , Rodrigo Ignacio Cuevas-Cid , Gisele Garcia Zanca","doi":"10.1016/j.pcd.2025.01.003","DOIUrl":"10.1016/j.pcd.2025.01.003","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed determine the prevalence of shoulder pain among Chilean patients with type 2 DM and to characterize their pain intensity and associated disabilities, including an analysis of sex-based differences.</div></div><div><h3>Methods</h3><div>A total of 151 participants with type 2 DM, aged 18–79, from family health centers in Talca, Chile, were included. Data were collected via telephone interview, capturing demographic details and information about current shoulder pain, including its duration, intensity, using a Numerical Rating Scale (NRS), and disability using the Shoulder Pain and Disability Index (SPADI). Statistical analysis was performed using frequency measures, Chi-squared tests, binary logistic regression, and Student's t-tests with SPSS version 21.0.</div></div><div><h3>Results</h3><div>Out of 1662 eligible patients, 151 participated. The overall prevalence of shoulder pain was 53.6 % (95 % CI: 53.8–53.4), with women showing a higher prevalence (63 %; 95 % CI: 63.2–62.8) compared to men (37 %; 95 % CI: 37.2–36.8), a difference that was statistically significant (chi-square=13.5; p ≤ 0.001). The results showed that neither BMI nor sex was significantly associated with the presence of pain. No significant differences were found between sexes regarding pain intensity and disability (p ≥ 0.05).</div></div><div><h3>Conclusion</h3><div>Shoulder pain is highly prevalent among patients with type 2 DM, with a higher prevalence in women. Future research should explore the impact of this condition on patients and develop targeted musculoskeletal rehabilitation programs.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 190-194"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The “Rightest” app connected to Rightest glucose meter via Bluetooth, helps to set blood glucose target and customize measurements. The app is provided with ketone alert when BG is ≥ 240 mg/dl.
Aim of the work
To assess the role of the rightest app in improving glycaemic control as well as quality of life in a 6- month interval of its usage.
Patients and methods
A clinical trial included 40 participants with type 1 diabetes, mean age 14.3 ± 1.42 years and diabetes duration of 4.5 ± 3.6 years regularly following up at Diabetes Unit. Rightest app was installed on the participants’ smart phone on enrollment and 6 months later assessment of the glycemic control was done by HbA1c and time in range. Results collected from app Quality of life (PedsQL) and user experience (UEQ) Questionnaires were applied at the end of the study.
Results
Using smartphone app yielded a significant reduction in mean BG level (-17.64 %, p = 0.012) that decreased HbA1c ( −10.63 %, p = 0.000). Increase of SMBG frequency was observed (p = 0.04). This is reflected on a 20 % increment time in range generated by app. (p-value = 0.002) and lower time above range (TAR > 180 mg/dl, −18.75 %, P = 0.001) in intervention group compared to control. However, the number of hypoglycemic events (p = 0.71) or DKA(p = 0.59) did not differ between groups. PedsQL questionnaire total score has improved (p-value = 0.010) in favor of intervention group with good experience with app indicated by UEQ. The pragmatic total score (1.425) of UEQ was above average while the hedonic total score was good (1.250) and overall score was good (1.338). The higher score of UEQ was inversely correlated with mean BG (r = -0.414, P = 0.008) and positively correlated to glycemic control (r = 0.644, p = 0.002).
Conclusion
Using mobile apps as an alternative for CGM in low resource settings can help improve glycemic control and quality of life for those who don’t have access to diabetes technology services because of unavailability or unaffordability.
{"title":"Diabetes self-management smartphone application: Could it be an alternative for continuous glucose monitoring in low resource settings?","authors":"Nancy Samir Elbarbary , Mohamed Osama Mohamed, Yasmeen Abdelaziz Fereig","doi":"10.1016/j.pcd.2025.02.002","DOIUrl":"10.1016/j.pcd.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>The “Rightest” app connected to Rightest glucose meter via Bluetooth, helps to set blood glucose target and customize measurements. The app is provided with ketone alert when BG is ≥ 240 mg/dl.</div></div><div><h3>Aim of the work</h3><div>To assess the role of the rightest app in improving glycaemic control as well as quality of life in a 6- month interval of its usage.</div></div><div><h3>Patients and methods</h3><div>A clinical trial included 40 participants with type 1 diabetes, mean age 14.3 ± 1.42 years and diabetes duration of 4.5 ± 3.6 years regularly following up at Diabetes Unit. Rightest app was installed on the participants’ smart phone on enrollment and 6 months later assessment of the glycemic control was done by HbA1c and time in range. Results collected from app Quality of life (PedsQL) and user experience (UEQ) Questionnaires were applied at the end of the study.</div></div><div><h3>Results</h3><div>Using smartphone app yielded a significant reduction in mean BG level (-17.64 %, p = 0.012) that decreased HbA1c ( −10.63 %, p = 0.000). Increase of SMBG frequency was observed (p = 0.04). This is reflected on a 20 % increment time in range generated by app. (p-value = 0.002) and lower time above range (TAR > 180 mg/dl, −18.75 %, P = 0.001) in intervention group compared to control. However, the number of hypoglycemic events (p = 0.71) or DKA(p = 0.59) did not differ between groups. PedsQL questionnaire total score has improved (p-value = 0.010) in favor of intervention group with good experience with app indicated by UEQ. The pragmatic total score (1.425) of UEQ was above average while the hedonic total score was good (1.250) and overall score was good (1.338). The higher score of UEQ was inversely correlated with mean BG (r = -0.414, P = 0.008) and positively correlated to glycemic control (r = 0.644, p = 0.002).</div></div><div><h3>Conclusion</h3><div>Using mobile apps as an alternative for CGM in low resource settings can help improve glycemic control and quality of life for those who don’t have access to diabetes technology services because of unavailability or unaffordability.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 157-164"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1016/j.pcd.2025.01.009
Esra Çavuşoğlu , Yasemin Çayir , Meral Gün
Aims
The aim was to determine food cravings and associated variables in patients with type 2 diabetes.
Methods
204 type 2 diabetes patients were enrolled in the cross-sectional study between February 16, 2024 and June 16, 2024. Data were collected face-to-face using personal information form, Food Cravings Scale and Diabetes Awareness and Acceptance Scale. Number, percentage, mean, standard deviation and minimum-maximum values, hierarchical regression analysis and pearson correlation test were used to analyze the data. The statistical significance level was assumed to be p < 0.05.
Results
The mean score on the food cravings scale was found to be 23.52 ± 19.44. Hierarchical regression analysis revealed that living alone, increased body mass index, alcohol consumption and hospitalization increased the food cravings in patients with type 2 diabetes. It was also found that the use of a diabetes-specific diet by participants, regular check-ups and high diabetes awareness and acceptance reduced the food cravings.
Conclusions
It has been shown that managing type 2 diabetes is a dynamic and multidimensional process that is influenced by the desire to eat, awareness of diabetes, knowledge and practices related to diabetes.
{"title":"Investigation of food cravings in individuals with type 2 diabetes: A hierarchical regression analysis","authors":"Esra Çavuşoğlu , Yasemin Çayir , Meral Gün","doi":"10.1016/j.pcd.2025.01.009","DOIUrl":"10.1016/j.pcd.2025.01.009","url":null,"abstract":"<div><h3>Aims</h3><div>The aim was to determine food cravings and associated variables in patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>204 type 2 diabetes patients were enrolled in the cross-sectional study between February 16, 2024 and June 16, 2024. Data were collected face-to-face using personal information form, Food Cravings Scale and Diabetes Awareness and Acceptance Scale. Number, percentage, mean, standard deviation and minimum-maximum values, hierarchical regression analysis and pearson correlation test were used to analyze the data. The statistical significance level was assumed to be p < 0.05.</div></div><div><h3>Results</h3><div>The mean score on the food cravings scale was found to be 23.52 ± 19.44. Hierarchical regression analysis revealed that living alone, increased body mass index, alcohol consumption and hospitalization increased the food cravings in patients with type 2 diabetes. It was also found that the use of a diabetes-specific diet by participants, regular check-ups and high diabetes awareness and acceptance reduced the food cravings.</div></div><div><h3>Conclusions</h3><div>It has been shown that managing type 2 diabetes is a dynamic and multidimensional process that is influenced by the desire to eat, awareness of diabetes, knowledge and practices related to diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 173-177"},"PeriodicalIF":2.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In diabetes, nutrition therapy necessitates effective management strategies to improve blood glucose levels, blood pressure, and lipid profiles, thereby lowering the risk of cardiovascular disease and stroke. Tableware is a food-level strategy to accurately measure food consumed and control food portion size. This prospective, randomized study investigated the impact of quantified tableware (QTW) on glycemic control in T2DM patients. Conducted at Mackay Memory Hospital, Taiwan, from August 2015 to December 2016, the study included 94 adult T2DM participants with poor glycemic control (HbA1c >7 %), randomly assigned to control (n = 47) and intervention (n = 47) groups. All participants received regular counseling from the dietician, while the intervention group additionally used a set of QTW designed by the Taiwanese Association of Diabetes Educators to accurately measure all the food consumed per meal in appropriate proportions. The primary aim was the change in HbA1c at 12 months. Secondary aims included achieving HbA1c < 7 %, BP < 140/90, and LDL < 100 mg/dl, known as the ABC goals (HbA1c, blood pressure, LDL). Seventy-seven patients, 43 in the control group and 34 in the intervention group completed the study. After 12 months, the intervention group showed a significant reduction in HbA1c levels compared to the control group (-0.7 ± 0.9 vs −0.2 ± 1.0 %, p = 0.037). Additionally, 32.4 % of the intervention group achieved HbA1c < 7 %, compared to 11.6 % in the control group (p = 0.026). Achievement of the LDL goal and any two of the ABC goals significantly increased only in the intervention group. Using QTW improved glycemic control and achievement of the LDL goal in T2DM patients. These results indicate that QTW can effectively enhance glycemic control, blood pressure, and lipid profiles in T2DM patients. Further studies are needed to confirm these findings and explore broader applications.
{"title":"Enhanced glycemic control and cardiovascular risk reduction in type 2 diabetes patients using quantified tableware: A randomized controlled study","authors":"Ching-Hsiang Leung , Min-Su Tzeng , Chia-Ying Tsai , Wan-Rong Tsai , Sung-Chen Liu , Pi-Hui Hsu , Shih-Ming Chuang","doi":"10.1016/j.pcd.2025.02.001","DOIUrl":"10.1016/j.pcd.2025.02.001","url":null,"abstract":"<div><div>In diabetes, nutrition therapy necessitates effective management strategies to improve blood glucose levels, blood pressure, and lipid profiles, thereby lowering the risk of cardiovascular disease and stroke. Tableware is a food-level strategy to accurately measure food consumed and control food portion size. This prospective, randomized study investigated the impact of quantified tableware (QTW) on glycemic control in T2DM patients. Conducted at Mackay Memory Hospital, Taiwan, from August 2015 to December 2016, the study included 94 adult T2DM participants with poor glycemic control (HbA1c >7 %), randomly assigned to control (n = 47) and intervention (n = 47) groups. All participants received regular counseling from the dietician, while the intervention group additionally used a set of QTW designed by the Taiwanese Association of Diabetes Educators to accurately measure all the food consumed per meal in appropriate proportions. The primary aim was the change in HbA1c at 12 months. Secondary aims included achieving HbA1c < 7 %, BP < 140/90, and LDL < 100 mg/dl, known as the ABC goals (HbA1c, blood pressure, LDL). Seventy-seven patients, 43 in the control group and 34 in the intervention group completed the study. After 12 months, the intervention group showed a significant reduction in HbA1c levels compared to the control group (-0.7 ± 0.9 vs −0.2 ± 1.0 %, p = 0.037). Additionally, 32.4 % of the intervention group achieved HbA1c < 7 %, compared to 11.6 % in the control group (p = 0.026). Achievement of the LDL goal and any two of the ABC goals significantly increased only in the intervention group. Using QTW improved glycemic control and achievement of the LDL goal in T2DM patients. These results indicate that QTW can effectively enhance glycemic control, blood pressure, and lipid profiles in T2DM patients. Further studies are needed to confirm these findings and explore broader applications.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 149-156"},"PeriodicalIF":2.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1016/j.pcd.2025.01.004
Kenni Wojujutari Ajele , Elmari Deacon
Aims
This study evaluated the effectiveness of cognitive-behavioural therapy (CBT) in managing comorbid depression and diabetes by examining its influence on psychological and metabolic outcomes, addressing inconsistencies in existing research.
Methods
A systematic review of 26 randomized controlled trials (RCTs) involving 4220 participants conducted between 2000 and 2024 was performed. Subgroup analyses evaluated geographic location, delivery modes, and intervention characteristics, including session duration and frequency.
Results
CBT significantly reduced depressive symptoms (SMD = –1.30, 95 % CI –2.46 to –0.13, p < 0.05), demonstrating substantial psychological benefits. Its effect on glycemic control, measured by HbA1c levels, was modest and not statistically significant (SMD = –0.56, 95 % CI –1.12–0.01, p > 0.05). Subgroup analyses revealed variations based on region and intervention characteristics. High heterogeneity across studies highlighted the need for tailored approaches that consider context-specific factors and delivery methods.
Conclusions
CBT effectively reduces depressive symptoms in individuals with diabetes, supporting its role in integrated care models. However, its association with glycemic control remains inconclusive. Future research should refine CBT protocols to enhance both psychological and metabolic outcomes while addressing diverse needs.
{"title":"Targeting depression and diabetes comorbidity: A generalization meta-analysis of randomized controlled trials on cognitive-behavioural therapy efficacy","authors":"Kenni Wojujutari Ajele , Elmari Deacon","doi":"10.1016/j.pcd.2025.01.004","DOIUrl":"10.1016/j.pcd.2025.01.004","url":null,"abstract":"<div><h3>Aims</h3><div>This study evaluated the effectiveness of cognitive-behavioural therapy (CBT) in managing comorbid depression and diabetes by examining its influence on psychological and metabolic outcomes, addressing inconsistencies in existing research.</div></div><div><h3>Methods</h3><div>A systematic review of 26 randomized controlled trials (RCTs) involving 4220 participants conducted between 2000 and 2024 was performed. Subgroup analyses evaluated geographic location, delivery modes, and intervention characteristics, including session duration and frequency.</div></div><div><h3>Results</h3><div>CBT significantly reduced depressive symptoms (SMD = –1.30, 95 % CI –2.46 to –0.13, p < 0.05), demonstrating substantial psychological benefits. Its effect on glycemic control, measured by HbA1c levels, was modest and not statistically significant (SMD = –0.56, 95 % CI –1.12–0.01, p > 0.05). Subgroup analyses revealed variations based on region and intervention characteristics. High heterogeneity across studies highlighted the need for tailored approaches that consider context-specific factors and delivery methods.</div></div><div><h3>Conclusions</h3><div>CBT effectively reduces depressive symptoms in individuals with diabetes, supporting its role in integrated care models. However, its association with glycemic control remains inconclusive. Future research should refine CBT protocols to enhance both psychological and metabolic outcomes while addressing diverse needs.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 93-102"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The three main sensory complications of Type 2 Diabetes are diabetic peripheral neuropathy (DPN), diabetic retinopathy (DR), and diabetic vestibulopathy (DV). Current screening for these has been found to be insufficient, and balance testing may be a way to improve screening practices. This study aims to assess if the presence of sensory complications can be used to predict balance scores.
Methods
52 participants with T2D were recruited for this study. Participants anthropometric measures, demographic, socioeconomic, and information related to the participants T2D were recorded. Participants completed the modified Clinical Test of Sensory Integration in Balance (mCTSIB) and scores were recorded. Bivariate analysis was conducted on all variables related to mCTSIB total balance scores. A multivariable linear regression model was created using mCTSIB total scores as the outcome and T2D sensory complications as the predictor while controlling for sex and age.
Results
Bivariate analysis revealed significant (p < 0.05) associations between mCTSIB total scores and T2D sensory complications, education, employment, annual income, and age. The final multivariate linear regression model was found to be significant (Adj R2 = 0.45, p < 0.01). This model showed that those with DPN (β = 121.03 cm, CI = 77.71–164.35, p < 0.01) or DV (β: 60.65, CI = 5.17–116.13, p = 0.04) had significantly higher balance scores compared to those that did not have a sensory complication, adjusting for sex and age.
Conclusion
Sensory complications of T2D have the potential to predict balance scores and provides the first evidence that balance assessments may also be able to screen for DPN and DV.
{"title":"Standing balance impairment in persons with type 2 diabetes is predicted by peripheral neuropathy and vestibulopathy","authors":"Trevor Lopatin , Kwame Sakyi , Bradley Kendall , George Grunberger , Joshua Haworth","doi":"10.1016/j.pcd.2024.12.003","DOIUrl":"10.1016/j.pcd.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The three main sensory complications of Type 2 Diabetes are diabetic peripheral neuropathy (DPN), diabetic retinopathy (DR), and diabetic vestibulopathy (DV). Current screening for these has been found to be insufficient, and balance testing may be a way to improve screening practices. This study aims to assess if the presence of sensory complications can be used to predict balance scores.</div></div><div><h3>Methods</h3><div>52 participants with T2D were recruited for this study. Participants anthropometric measures, demographic, socioeconomic, and information related to the participants T2D were recorded. Participants completed the modified Clinical Test of Sensory Integration in Balance (mCTSIB) and scores were recorded. Bivariate analysis was conducted on all variables related to mCTSIB total balance scores. A multivariable linear regression model was created using mCTSIB total scores as the outcome and T2D sensory complications as the predictor while controlling for sex and age.</div></div><div><h3>Results</h3><div>Bivariate analysis revealed significant (p < 0.05) associations between mCTSIB total scores and T2D sensory complications, education, employment, annual income, and age. The final multivariate linear regression model was found to be significant (Adj R<sup>2</sup> = 0.45, p < 0.01). This model showed that those with DPN (β = 121.03 cm, CI = 77.71–164.35, p < 0.01) or DV (β: 60.65, CI = 5.17–116.13, p = 0.04) had significantly higher balance scores compared to those that did not have a sensory complication, adjusting for sex and age.</div></div><div><h3>Conclusion</h3><div>Sensory complications of T2D have the potential to predict balance scores and provides the first evidence that balance assessments may also be able to screen for DPN and DV.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 35-39"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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