Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression
Aims Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review aimed to determine the effectiveness of group‐based interventions compared with individual interventio...
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| Veröffentlicht in: | Diabetic medicine 2017-08, Vol.34 (8), p.1027-1039 |
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| creator | Odgers‐Jewell, K. Ball, L. E. Kelly, J. T. Isenring, E. A. Reidlinger, D. P. Thomas, R. |
| description | Aims
Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review aimed to determine the effectiveness of group‐based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Methods
Six electronic databases were searched. Group‐based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self‐efficacy.
Results
Fifty‐three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group‐based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group‐based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer‐led interventions.
Conclusions
Group‐based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
What's new?
We present a comprehensive up‐to‐date review of the evidence for the effectiveness of Type 2 diabetes group‐based interventions. This is the first review in the area to complete a meta‐regression.
We report statistically significant results for improving HbA1c, fasting blood glucose, body weight, waist circumference, triglycerides and diabetes knowledge, but clinical improvement is more nuanced.
Group‐based interventions facilitated by a single discipline, mu |
| doi_str_mv | 10.1111/dme.13340 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1871550564</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1919388944</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3880-5e275d5558fba2c99289b7ad42065e81094a662284f883e3a17fff706a3fc2c03</originalsourceid><addsrcrecordid>eNp1kUtuFDEQhq0IlAwJi1wAWWIDi0787Lazi8LwkIKyCeuW2y5PHPVjYnfPqHccgRtwN06CQycskPDGcunzV1X6ETql5Izmc-46OKOcC3KAVlSUopBC0xdoRSrBCk4qeoRepXRPCGWa60N0xBRjJSNkhX6uvQc7hh30kBIePN7EYdr--v6jMQkcTtD6_OhMbzbQQT9icJM1Yxh67IeIQ-_CLrjJtAnvw3iHb-ctYIZdMA2MkC6wwWlOI3T5j8URdgH2C9nBaLI6m9s5QcKmd8-1CJuYx8lNTtBLn93w-uk-Rt8-rm-vPhfXN5--XF1eF5YrRQoJrJJOSql8Y5jVmindVMYJRkoJihItTFkypoRXigM3tPLeV6Q03FtmCT9G7xbvNg4PE6Sx7kKy0Lamh2FKNVUVlZLIUmT07T_o_TDFvEWmNNV5Hi0eqfcLZeOQUgRfb2PoTJxrSurH1OqcWv0ntcy-eTJOTQfuL_kcUwbOF2AfWpj_b6o_fF0vyt9z1KbX</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1919388944</pqid></control><display><type>article</type><title>Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Odgers‐Jewell, K. ; Ball, L. E. ; Kelly, J. T. ; Isenring, E. A. ; Reidlinger, D. P. ; Thomas, R.</creator><creatorcontrib>Odgers‐Jewell, K. ; Ball, L. E. ; Kelly, J. T. ; Isenring, E. A. ; Reidlinger, D. P. ; Thomas, R.</creatorcontrib><description>Aims
Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review aimed to determine the effectiveness of group‐based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Methods
Six electronic databases were searched. Group‐based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self‐efficacy.
Results
Fifty‐three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group‐based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group‐based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer‐led interventions.
Conclusions
Group‐based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
What's new?
We present a comprehensive up‐to‐date review of the evidence for the effectiveness of Type 2 diabetes group‐based interventions. This is the first review in the area to complete a meta‐regression.
We report statistically significant results for improving HbA1c, fasting blood glucose, body weight, waist circumference, triglycerides and diabetes knowledge, but clinical improvement is more nuanced.
Group‐based interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters appear to be more effective at improving HbA1c than peer‐led interventions.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.13340</identifier><identifier>PMID: 28226200</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Blood pressure ; Body mass ; Body mass index ; Body weight ; Body Weight Maintenance ; Combined Modality Therapy ; Controlled Clinical Trials as Topic ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - therapy ; Evidence-Based Medicine ; Fasting ; Glucose ; Glycated Hemoglobin A - analysis ; Group Structure ; Healthy Lifestyle ; Hemoglobin ; Humans ; Hyperglycemia - prevention & control ; Laboratory testing ; Medical personnel ; Middle Aged ; Overweight - complications ; Overweight - prevention & control ; Overweight - therapy ; Patient Care Team ; Patient Education as Topic ; Peer Group ; Psychosocial Support Systems ; Randomized Controlled Trials as Topic ; Reviews ; Self-Management - education ; Statistical analysis ; Systematic review ; Triglycerides ; Weight Loss</subject><ispartof>Diabetic medicine, 2017-08, Vol.34 (8), p.1027-1039</ispartof><rights>2017 Diabetes UK</rights><rights>2017 Diabetes UK.</rights><rights>Diabetic Medicine © 2017 Diabetes UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3880-5e275d5558fba2c99289b7ad42065e81094a662284f883e3a17fff706a3fc2c03</citedby><cites>FETCH-LOGICAL-c3880-5e275d5558fba2c99289b7ad42065e81094a662284f883e3a17fff706a3fc2c03</cites><orcidid>0000-0002-1453-4447</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.13340$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.13340$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28226200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Odgers‐Jewell, K.</creatorcontrib><creatorcontrib>Ball, L. E.</creatorcontrib><creatorcontrib>Kelly, J. T.</creatorcontrib><creatorcontrib>Isenring, E. A.</creatorcontrib><creatorcontrib>Reidlinger, D. P.</creatorcontrib><creatorcontrib>Thomas, R.</creatorcontrib><title>Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aims
Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review aimed to determine the effectiveness of group‐based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Methods
Six electronic databases were searched. Group‐based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self‐efficacy.
Results
Fifty‐three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group‐based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group‐based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer‐led interventions.
Conclusions
Group‐based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
What's new?
We present a comprehensive up‐to‐date review of the evidence for the effectiveness of Type 2 diabetes group‐based interventions. This is the first review in the area to complete a meta‐regression.
We report statistically significant results for improving HbA1c, fasting blood glucose, body weight, waist circumference, triglycerides and diabetes knowledge, but clinical improvement is more nuanced.
Group‐based interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters appear to be more effective at improving HbA1c than peer‐led interventions.</description><subject>Blood pressure</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body weight</subject><subject>Body Weight Maintenance</subject><subject>Combined Modality Therapy</subject><subject>Controlled Clinical Trials as Topic</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Evidence-Based Medicine</subject><subject>Fasting</subject><subject>Glucose</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Group Structure</subject><subject>Healthy Lifestyle</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hyperglycemia - prevention & control</subject><subject>Laboratory testing</subject><subject>Medical personnel</subject><subject>Middle Aged</subject><subject>Overweight - complications</subject><subject>Overweight - prevention & control</subject><subject>Overweight - therapy</subject><subject>Patient Care Team</subject><subject>Patient Education as Topic</subject><subject>Peer Group</subject><subject>Psychosocial Support Systems</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Reviews</subject><subject>Self-Management - education</subject><subject>Statistical analysis</subject><subject>Systematic review</subject><subject>Triglycerides</subject><subject>Weight Loss</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtuFDEQhq0IlAwJi1wAWWIDi0787Lazi8LwkIKyCeuW2y5PHPVjYnfPqHccgRtwN06CQycskPDGcunzV1X6ETql5Izmc-46OKOcC3KAVlSUopBC0xdoRSrBCk4qeoRepXRPCGWa60N0xBRjJSNkhX6uvQc7hh30kBIePN7EYdr--v6jMQkcTtD6_OhMbzbQQT9icJM1Yxh67IeIQ-_CLrjJtAnvw3iHb-ctYIZdMA2MkC6wwWlOI3T5j8URdgH2C9nBaLI6m9s5QcKmd8-1CJuYx8lNTtBLn93w-uk-Rt8-rm-vPhfXN5--XF1eF5YrRQoJrJJOSql8Y5jVmindVMYJRkoJihItTFkypoRXigM3tPLeV6Q03FtmCT9G7xbvNg4PE6Sx7kKy0Lamh2FKNVUVlZLIUmT07T_o_TDFvEWmNNV5Hi0eqfcLZeOQUgRfb2PoTJxrSurH1OqcWv0ntcy-eTJOTQfuL_kcUwbOF2AfWpj_b6o_fF0vyt9z1KbX</recordid><startdate>201708</startdate><enddate>201708</enddate><creator>Odgers‐Jewell, K.</creator><creator>Ball, L. E.</creator><creator>Kelly, J. T.</creator><creator>Isenring, E. A.</creator><creator>Reidlinger, D. P.</creator><creator>Thomas, R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1453-4447</orcidid></search><sort><creationdate>201708</creationdate><title>Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression</title><author>Odgers‐Jewell, K. ; Ball, L. E. ; Kelly, J. T. ; Isenring, E. A. ; Reidlinger, D. P. ; Thomas, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3880-5e275d5558fba2c99289b7ad42065e81094a662284f883e3a17fff706a3fc2c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Blood pressure</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body weight</topic><topic>Body Weight Maintenance</topic><topic>Combined Modality Therapy</topic><topic>Controlled Clinical Trials as Topic</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Evidence-Based Medicine</topic><topic>Fasting</topic><topic>Glucose</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Group Structure</topic><topic>Healthy Lifestyle</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hyperglycemia - prevention & control</topic><topic>Laboratory testing</topic><topic>Medical personnel</topic><topic>Middle Aged</topic><topic>Overweight - complications</topic><topic>Overweight - prevention & control</topic><topic>Overweight - therapy</topic><topic>Patient Care Team</topic><topic>Patient Education as Topic</topic><topic>Peer Group</topic><topic>Psychosocial Support Systems</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Reviews</topic><topic>Self-Management - education</topic><topic>Statistical analysis</topic><topic>Systematic review</topic><topic>Triglycerides</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Odgers‐Jewell, K.</creatorcontrib><creatorcontrib>Ball, L. E.</creatorcontrib><creatorcontrib>Kelly, J. T.</creatorcontrib><creatorcontrib>Isenring, E. A.</creatorcontrib><creatorcontrib>Reidlinger, D. P.</creatorcontrib><creatorcontrib>Thomas, R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Odgers‐Jewell, K.</au><au>Ball, L. E.</au><au>Kelly, J. T.</au><au>Isenring, E. A.</au><au>Reidlinger, D. P.</au><au>Thomas, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2017-08</date><risdate>2017</risdate><volume>34</volume><issue>8</issue><spage>1027</spage><epage>1039</epage><pages>1027-1039</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Aims
Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review aimed to determine the effectiveness of group‐based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Methods
Six electronic databases were searched. Group‐based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self‐efficacy.
Results
Fifty‐three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group‐based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group‐based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer‐led interventions.
Conclusions
Group‐based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
What's new?
We present a comprehensive up‐to‐date review of the evidence for the effectiveness of Type 2 diabetes group‐based interventions. This is the first review in the area to complete a meta‐regression.
We report statistically significant results for improving HbA1c, fasting blood glucose, body weight, waist circumference, triglycerides and diabetes knowledge, but clinical improvement is more nuanced.
Group‐based interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters appear to be more effective at improving HbA1c than peer‐led interventions.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28226200</pmid><doi>10.1111/dme.13340</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-1453-4447</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Blood pressure Body mass Body mass index Body weight Body Weight Maintenance Combined Modality Therapy Controlled Clinical Trials as Topic Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - therapy Evidence-Based Medicine Fasting Glucose Glycated Hemoglobin A - analysis Group Structure Healthy Lifestyle Hemoglobin Humans Hyperglycemia - prevention & control Laboratory testing Medical personnel Middle Aged Overweight - complications Overweight - prevention & control Overweight - therapy Patient Care Team Patient Education as Topic Peer Group Psychosocial Support Systems Randomized Controlled Trials as Topic Reviews Self-Management - education Statistical analysis Systematic review Triglycerides Weight Loss |
| title | Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression |
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