Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis

Bibliographic Details
Title: Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis
Authors: Jacinto Muñoz-Pardeza, José Francisco López-Gil, Nidia Huerta-Uribe, Ignacio Hormazábal-Aguayo, Mikel Izquierdo, Antonio García-Hermoso
Source: Cardiovascular Diabetology, Vol 23, Iss 1, Pp 1-12 (2024)
Publisher Information: BMC, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: Adolescence, Childhood, Diet, Exercise, Glucose, Glycosylated haemoglobin, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: Abstract The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine which interventions could provide the most significant benefits for the metabolic health of young individuals with type 1 diabetes mellitus. The aim of this study was to identify optimal nonpharmacological interventions on glycaemic control, measured by glycated haemoglobin (HbA1c), in children and adolescents with type 1 diabetes. Systematic searches were conducted in PubMed, Web of Science, Scopus, and SPORTDiscus from inception to July 1, 2023. Randomised clinical trials (RCT) investigating nonpharmacological interventions (e.g., physical activity, nutrition, and behavioural therapies) were included. Primary outcome was change in HbA1c levels. Secondary outcome was change in daily insulin dose requirement. Seventy-four RCT with 6,815 participants (49.43% girls) involving 20 interventions were analysed using a network meta-analysis. Most interventions showed greater efficacy than standard care. However, multicomponent exercise, which includes aerobic and strength training (n = 214, standardised mean difference [SMD] =– 0.63, 95% credible interval [95% CrI] – 1.09 to – 0.16) and nutritional supplements (n = 146, SMD =– 0.49, – 0 .92 to – 0.07) demonstrated the greatest HbA1c reductions. These interventions also led to the larger decreases in daily insulin needs (n = 119, SMD =– 0.79, 95% CrI – 1.19 to – 0.34) and (n = 57, SMD =– 0.62, 95% CrI – 1.18 to – 0.12, respectively). The current study underscores non-pharmacological options such as multicomponent exercise and nutritional supplements, showcasing their potential to significantly improve HbA1c in youth with type 1 diabetes. Although additional research to confirm their efficacy is required, these approaches could be considered as potential adjuvant therapeutic options in the management of type 1 diabetes among children and adolescents.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1475-2840
Relation: https://doaj.org/toc/1475-2840
DOI: 10.1186/s12933-024-02301-3
Access URL: https://doaj.org/article/2b90b9ee769448e0958704871771be75
Accession Number: edsdoj.2b90b9ee769448e0958704871771be75
Database: Directory of Open Access Journals
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More Details
ISSN:14752840
DOI:10.1186/s12933-024-02301-3
Published in:Cardiovascular Diabetology
Language:English