scholarly journals The efficacy and safety of Momordica charantia L. in animal models of type 2 diabetes mellitus; A systematic review and meta-analysis

2019 ◽  
Author(s):  
Emanuel L. Peter ◽  
Prakash B. Nagendrappa ◽  
Anita Kaligirwa ◽  
Patrick Engeu Ogwang ◽  
Crispin Duncan Sesaazi
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Animal Models ◽  
Publication Bias ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Risk Of Bias

AbstractBackgroundMomordica charantia L. (Cucurbitaceae) has been used to control hyperglycemia in people with type 2 diabetes mellitus in Asia, South America, and Africa for decades. However, a meta-analysis of clinical trials confirmed very low-quality evidence of its efficacy. To potentially increase the certainty of evidence, we evaluated the effect of M. charantia L. in comparison with vehicle on glycemic control in animal models of type 2 diabetes mellitus.MethodsReview authors searched in MEDLINE, Web of Science, Scopus, and CINAHL databases without language restriction through April 2019. Two authors independently evaluated full texts, assessed the risk of bias, and extracted data. We analyzed the influence of study design and evidence of publication bias.ResultsThe review included 66 studies involving 1861 animals. They had a follow up between 7 and 90 days. Majority 29 (43.9%) used Wistar albino rats, and 37 (56.1%) used male animals. Thirty-two (48%) used an aqueous extract of fresh fruits. M. charantia L. reduced fasting plasma glucose (FPG) and glycosylated hemoglobin A1c in comparison to vehicle control (42 studies, 815 animals; SMD, −6.86 [95% CI; −7.95, −5.77], 3 studies, 59 animals; SMD; −7.76 [95%CI; −12.50, −3.01]) respectively. Magnitude of FPG was large in Wistar albino rat subgroup; SMD; −10.29, [95%CI; −12.55, −8.03]. Publication bias changed FPG to non-significant −2.46 SMD, [95%CI; - 5.10, 0.17]. We downgraded the evidence to moderate quality due to poor methodological quality, high risk of bias, unexplained heterogeneity, suspected publication bias, and lack of standardized dose.ConclusionM. charantia L. lowers elevated plasma glucose level in type 2 diabetes mellitus animal models. Publication bias and poor methodological quality call for future researches to focus on standardizing dose with chemical markers and provide measures to improve preclinical type 2 diabetes mellitus studies.Systematic review registration CRD42019119181

Abstract MP92: Processed and Unprocessed Red Meat Consumption and Incident Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Martha Tamez ◽  
Renata Micha ◽  
Martin Lajous ◽  
Dariush Mozaffarian
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Publication Bias ◽  
Meta Analysis ◽  
Meat Consumption ◽  
Red Meat ◽  
Processed Meats

Background: Several studies have recently evaluated the relation of processed and unprocessed red meat consumption and type 2 diabetes mellitus (DM). An updated review and quantitative assessment of these studies is crucial for public health recommendations. Methods: We performed a systematic review and meta-analysis of the relation of processed (salted or otherwise preserved), unprocessed, and total red meat consumption with DM. We updated a prior systematic search (to Mar 2009) for additional cohort, case-control, or randomized studies through Oct 2012. Among prior identified studies and 208 newly identified abstracts, 13 studies, all prospective cohorts, met inclusion criteria. These included 4 prior identified studies, 3 updated analyses, and 6 new cohorts. Data were extracted independently in duplicate. Random-effects generalized least squares models for trend were used to derive pooled dose-response estimates. Statistical heterogeneity between studies was tested with goodness of fit (λ2), and publication bias by funnel plots and Begg’s test. Results: The 13 studies provided 34 separate estimates for relations of processed, unprocessed, and total red meat consumption with incident DM. These included 574,212 individuals and 33,482 DM cases. In pooled analyses, per 50-g serving/d of processed meats, DM risk was 35% higher (13 studies; 34,077 cases; RR 1.35; 95% CI, 1.24-1.55; P<0.001). The latter corresponded to 82% higher DM risk (RR 1.82; 95% CI, 1.64-2.02; P<0.001) for each 100-g serving/d of processed meats. Per 100-g serving/d of unprocessed red meats, 13% higher risk of DM was seen (12 studies; 31 591 cases; RR 1.13; 95% CI, 1.08-1.17; P<0.001). Fewer studies evaluated total red meat, with intermediate results (5 studies; 16,747 cases; RR per 100-g serving/d 1.16; 95% CI, 1.11-1.21; P<0.001). Heterogeneity was evident by study location, with stronger risk estimates in US vs European populations. Evidence for publication bias was not seen. Conclusions: Consumption of red meat is associated with high incidence of DM. Per gram, risk is highest for processed meats, highlighting the need for investigation of key responsible constituents and informing policy priorities.

scholarly journals Weight maintenance interventions for people with type 2 diabetes mellitus: a systematic review protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Sarah Sauchelli ◽  
Julia Bradley ◽  
Jennifer Cox ◽  
Clare England ◽  
Rachel Perry
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Weight Maintenance ◽  
Risk Of Bias

Abstract Background Weight loss maintenance is a challenge for people with type 2 diabetes mellitus (T2DM), which attenuates the long-term benefits of weight loss for diabetes management. Medication, specific dietary requirements and the psychosocial burden of T2DM signify that weight loss maintenance designed for obesity may not suit people with T2DM. The primary objective of this review is to comprehensively evaluate existing weight maintenance interventions for people with or at high risk of T2DM. Methods We registered a protocol for the systematic review and meta-analysis of randomised and non-randomised weight maintenance interventions for T2DM. Studies included will have been carried out in adults with clinical diagnosis of T2DM or pre-diabetes. All intervention types will be accepted (e.g. behavioural/lifestyle change and pharmacological). The primary outcomes will be weight control, glycaemic control and adverse effects. Secondary outcomes will include cardiovascular risk factors (e.g. total cholesterol, LDL-cholesterol, blood pressure control), psychological wellbeing (including health-related quality of life), change in glucose medication and waist circumference. Multiple electronic databases will be searched such as MEDLINE, EMBASE, Web of Science, PsychINFO and international registers (e.g. Cochrane Central Register of Controlled Trials, WHO ICTRP). OpenGrey will be searched for grey literature. Two researchers will screen all citations and abstracts. This process will also be conducted by an additional researcher using a semi-automated tool to reduce human error. Full-text articles will be further examined by the researchers to select a final set for further analysis, and a narrative synthesis of the evidence will be presented. Potential sources of heterogeneity will be assessed, and a meta-analysis will be conducted if feasible. Risk of bias will be evaluated using the Cochrane risk of bias tool and the certainty of evidence using the GRADE (grading of recommendations, assessment, development and evaluation) approach. Discussion This review will critically appraise existing weight maintenance interventions targeting T2DM. Findings will inform future intervention development to support people with T2DM delay weight regain and prolong successful diabetes management. Systematic review registration PROSPERO CRD42020168032

scholarly journals Effectiveness of Social Cognitive Theory–Based Interventions for Glycemic Control in Adults With Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Yvonne Smith ◽  
Rosalia Garcia-Torres ◽  
Steven S Coughlin ◽  
Jiying Ling ◽  
Terri Marin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Meta Analysis ◽  
Risk Of Bias

BACKGROUND For those living with type 2 diabetes mellitus (T2DM), failing to engage in self-management behaviors leads to poor glycemic control. Social cognitive theory (SCT) has been shown to improve health behaviors by altering cognitive processes and increasing an individual’s belief in their ability to accomplish a task. OBJECTIVE We aim to present a protocol for a systematic review and meta-analysis to systematically identify, evaluate, and analyze the effect of SCT-based interventions to improve glycemic control in adults with T2DM. METHODS This protocol follows the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Data sources will include PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Cochrane Library, and Web of Science, and data will be reviewed with the use of customized text mining software. Studies examining SCT-based behavioral interventions for adults diagnosed with T2DM in randomized controlled trials located in the outpatient setting will be included. Intervention effectiveness will be compared with routine care. Screening and data collection will be performed in multiple stages with three reviewers as follows: (1) an independent review of titles/abstracts, (2) a full review, and (3) data collection with alternating teams of two reviewers for disputes to be resolved by a third reviewer. Study quality and risk of bias will be assessed by three reviewers using the Cochrane risk of bias tool. Standardized mean differences will be used to describe the intervention effect sizes with regard to self-efficacy and diabetes knowledge. The raw mean difference of HbA1c will be provided in a random effects model and presented in a forest plot. The expected limitations of this study are incomplete data, the need to contact authors, and analysis of various types of glycemic control measures accurately within the same data set. RESULTS This protocol was granted institutional review board exemption on October 7, 2019. PROSPERO registration (ID: CRD42020147105) was received on April 28, 2020. The review began on April 29, 2020. The results of the review will be disseminated through conference presentations, peer-reviewed journals, and meetings. CONCLUSIONS This systematic review will appraise the effectiveness of SCT-based interventions for adults diagnosed with T2DM and provide the most effective interventions for improving health behaviors in these patients. CLINICALTRIAL PROSPERO CRD42020147105; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=147105 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/17148

scholarly journals Weight maintenance interventions for people with type 2 diabetes mellitus: A systematic review protocol

2020 ◽  
Author(s):  
Sarah Sauchelli ◽  
Julia Bradley ◽  
Jennifer Cox ◽  
Clare England ◽  
Rachel Perry
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Weight Maintenance ◽  
Risk Of Bias

Abstract Background: Weight loss maintenance is a challenge for people with Type 2 Diabetes Mellitus (T2DM), which attenuates the long-term benefits of weight loss for diabetes management. Medication, specific dietary requirements, and the psychosocial burden of T2DM signify that weight loss maintenance designed for obesity may not suit people with T2DM. The primary objective of this review is to comprehensively evaluate existing weight maintenance interventions for people with or at high risk of T2DM. Methods: We registered a protocol for the systematic review and meta-analysis of randomised and non-randomised weight maintenance interventions for T2DM. Studies included will have been carried out in adults with clinical diagnosis of T2DM or pre-diabetes. All intervention types will be accepted (e.g. behavioural/lifestyle change and pharmacological). The primary outcomes will be weight control, glycaemic control, and adverse effects. Secondary outcomes will include cardiovascular risk factors (e.g. total cholesterol, LDL-cholesterol, blood pressure control), psychological wellbeing (including health-related quality of life), change in glucose medication and waist circumference. Multiple electronic databases will be searched such as MEDLINE, EMBASE, Web of Science, PsychINFO and international registers (e.g. Cochrane Central Register of Controlled Trials, WHO ICTRP). OpenGrey will be searched for grey literature. Two researchers will screen all citations and abstracts. This process will also be conducted by an additional researcher using a semi-automated tool to reduce human error. Full-text articles will be further examined by the researchers to select a final set for further analysis, and a narrative synthesis of the evidence will be presented. Potential sources of heterogeneity will be assessed, and a meta-analysis will be conducted if feasible. Risk of bias will be evaluated using the Cochrane risk of bias tool and the certainty of evidence using the GRADE (grading of recommendations, assessment, development, and evaluation) approach. Discussion: This review will critically appraise existing weight maintenance interventions targeting T2DM. Findings will inform future intervention development to support people with T2DM delay weight regain and prolong successful diabetes management. Systematic Review Registration: PROSPERO 168032

scholarly journals Effectiveness of Social Cognitive Theory–Based Interventions for Glycemic Control in Adults With Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis

10.2196/17148 ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. e17148
Author(s):  
Yvonne Smith ◽  
Rosalia Garcia-Torres ◽  
Steven S Coughlin ◽  
Jiying Ling ◽  
Terri Marin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Meta Analysis ◽  
Risk Of Bias

Background For those living with type 2 diabetes mellitus (T2DM), failing to engage in self-management behaviors leads to poor glycemic control. Social cognitive theory (SCT) has been shown to improve health behaviors by altering cognitive processes and increasing an individual’s belief in their ability to accomplish a task. Objective We aim to present a protocol for a systematic review and meta-analysis to systematically identify, evaluate, and analyze the effect of SCT-based interventions to improve glycemic control in adults with T2DM. Methods This protocol follows the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Data sources will include PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Cochrane Library, and Web of Science, and data will be reviewed with the use of customized text mining software. Studies examining SCT-based behavioral interventions for adults diagnosed with T2DM in randomized controlled trials located in the outpatient setting will be included. Intervention effectiveness will be compared with routine care. Screening and data collection will be performed in multiple stages with three reviewers as follows: (1) an independent review of titles/abstracts, (2) a full review, and (3) data collection with alternating teams of two reviewers for disputes to be resolved by a third reviewer. Study quality and risk of bias will be assessed by three reviewers using the Cochrane risk of bias tool. Standardized mean differences will be used to describe the intervention effect sizes with regard to self-efficacy and diabetes knowledge. The raw mean difference of HbA1c will be provided in a random effects model and presented in a forest plot. The expected limitations of this study are incomplete data, the need to contact authors, and analysis of various types of glycemic control measures accurately within the same data set. Results This protocol was granted institutional review board exemption on October 7, 2019. PROSPERO registration (ID: CRD42020147105) was received on April 28, 2020. The review began on April 29, 2020. The results of the review will be disseminated through conference presentations, peer-reviewed journals, and meetings. Conclusions This systematic review will appraise the effectiveness of SCT-based interventions for adults diagnosed with T2DM and provide the most effective interventions for improving health behaviors in these patients. Trial Registration PROSPERO CRD42020147105; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=147105 International Registered Report Identifier (IRRID) PRR1-10.2196/17148

scholarly journals Impact of DSMES app interventions on medication adherence in type 2 diabetes mellitus: systematic review and meta-analysis

2021 ◽  
Vol 28 (1) ◽  
pp. e100291
Author(s):  
Dumisani Enricho Nkhoma ◽  
Charles Jenya Soko ◽  
Kondwani Joseph Banda ◽  
David Greenfield ◽  
Yu-Chuan (Jack) Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Usual Care ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Moderate Risk

ObjectivesTo conduct systematic review and meta-analysis of interventional studies to investigate the impact of diabetes self-management education and support (DSMES) apps on adherence in patients with type 2 diabetes mellitus (T2D).MethodsPubMed, Embase, CENTRAL, Web of Science, Scopus and ProQuest were searched, in addition to references of identified articles and similar reviews. Experimental studies, reported in English, assessing DSMES app intervention’s impact on adherence and clinical outcomes of patients with T2D compared with usual care were included. Study bias was assessed using Cochrane Risk of Bias V.2.0 tool. Analysis plan involved narrative synthesis, moderator and meta-analysis.ResultsSix randomised controlled trials were included, involving 696 participants (average age 57.6 years, SD 10.59). Mobile apps were mostly used for imputing clinical data, dietary intake or physical activity, and transmitting information to the provider. At 3 months, DSMES apps proved effective in improving medication adherence (standardized mean difference (SMD)=0.393, 95% CI 0.17 to 0.61), glycated haemoglobin (HbA1c) (mean difference (MD)=−0.314, 95% CI −0.477 to –0.151) and Body Mass Index (BMI) (MD=−0.28, 95% CI −0.545 to –0.015). All pooled estimates had low heterogeneity (I2 0%). Four studies had moderate risk of bias while one each was judged to be low and high risks, respectively.ConclusionDSMES apps had significant small to moderate effects on medication adherence, HbA1c and BMI of patients with T2D compared with usual care. Apps were described as reliable, easy to use and convenient, though participants were required to be phone literate. Evidence comes from feasibility trials with generally moderate risk of bias. Larger trials with longer follow-up periods using theory-based interventions are required to improve current evidence.

scholarly journals Weight maintenance interventions for people with type 2 diabetes mellitus: A systematic review protocol

2020 ◽  
Author(s):  
Sarah Sauchelli ◽  
Julia Bradley ◽  
Jennifer Cox ◽  
Clare England ◽  
Rachel Perry
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Weight Maintenance ◽  
Risk Of Bias

Abstract Background: Weight loss maintenance is a challenge for people with Type 2 Diabetes Mellitus (T2DM), which attenuates the long-term benefits of weight loss for diabetes management. Medication, specific dietary requirements, and the psychosocial burden of T2DM signify that weight loss maintenance designed for obesity may not suit people with T2DM. The primary objective of this review is to comprehensively evaluate existing weight maintenance interventions for people with or at high risk of T2DM.Methods: We registered a protocol for the systematic review and meta-analysis of randomised and non-randomised weight maintenance interventions for T2DM. Studies included will have been carried out in adults with clinical diagnosis of T2DM or pre-diabetes. All intervention types will be accepted (e.g. behavioural/lifestyle change and pharmacological). The primary outcomes will be weight control, glycaemic control, and adverse effects. Secondary outcomes will include cardiovascular risk factors (e.g. total cholesterol, LDL-cholesterol, blood pressure control), psychological wellbeing (including health-related quality of life), change in glucose medication and waist circumference. Multiple electronic databases will be searched such as MEDLINE, EMBASE, Web of Science, PsychINFO and international registers (e.g. Cochrane Central Register of Controlled Trials, WHO ICTRP). OpenGrey will be searched for grey literature. Two researchers will screen all citations and abstracts. This process will also be conducted by an additional researcher using a semi-automated tool to reduce human error. Full-text articles will be further examined by the researchers to select a final set for further analysis, and a narrative synthesis of the evidence will be presented. Potential sources of heterogeneity will be assessed, and a meta-analysis will be conducted if feasible. Risk of bias will be evaluated using the Cochrane risk of bias tool and the certainty of evidence using the GRADE (grading of recommendations, assessment, development, and evaluation) approach.Discussion: This review will critically appraise existing weight maintenance interventions targeting T2DM. Findings will inform future intervention development to support people with T2DM delay weight regain and prolong successful diabetes management.Systematic Review Registration: PROSPERO CRD42020168032

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