Diabetes Q&A

How Beneficial are Behavioral Programs to Patients with Diabetes?

Behavioral programs and self-management education—especially those without added support—offer little benefits to patients with both type 1 and type 2 diabetes, according to 2 recent studies.

While there are a large variety of behavioral interventions available for patients with diabetes, it is unclear how effective these programs are, and how to best optimize them.

In order to further examine this issue, researchers conducted 2 meta-analyses of data from between 1993 and 2015 and conference proceedings from 2011 to 2014.
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In the first study, researchers used data from 132 randomized, controlled trials evaluating behavioral programs against usual care and controls in patients with type 2 diabetes.1

They found that the majority of lifestyle and diabetes self-management education and support programs (offering ≥11 hours of contact with a health care provider) were associated with clinically significant improvements in glycemic control, while programs without added support (<10 hours of contact) provided little benefit to patients.

Programs delivered in person rather than through technology showed the greatest effects, while lifestyle programs led to the greatest reductions in BMI.

In the second study, researchers identified 35 prospective controlled studies comparing behavioral programs with usual care and controls in patients with type 1 diabetes.2

Overall, they found that behavioral programs were associated with lower HbA1c at 6 months after the intervention compared with usual care. Although, at 12 months follow-up or longer, there were no statistically significant differences between behavioral programs, usual care, and controls in HbA1c levels or quality of life. 

“At this time, clinicians still must monitor patients after participating in these programs, should additional means be necessary to control their disease more adequately to prevent devastating complications,” they concluded.1

—Michael Potts

References:

  1. Pillay J, Armstrong MJ, Butalia S, et al. Behavioral programs for type 2 diabetes mellitus: a systematic review and network meta-analysis for effect moderation. Ann Intern Med. September 29, 2015 [epub ahead of print]. doi:10.7326/M15-1400.
  2. Pillay J, Armstrong MJ, Butalia S, et al. Behavioral programs for type 1 diabetes mellitus: a systematic review and meta-analysis. September 29, 2015 [epub ahead of print]. doi:10.7326/M15-1399.