ResearchPad - systematic-review-or-meta‐analysis https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Systematic review and meta‐analysis of randomized controlled trials of psychological interventions to improve glycaemic control in children and adults with type 1 diabetes]]> https://www.researchpad.co/article/elastic_article_6927 A previous systematic review and meta‐analysis of randomized controlled trials (RCT) of psychological interventions to improve glycaemic control demonstrated an effect for children with type 1 diabetes but not adults, with a reduction in HbA1c of 5 mmol/mol (0.5%).The current review synthesized data from nine adult (n = 1102) and 20 child RCTs (n = 2567) in an aggregate meta‐analysis; there was no improvement/reduction in HbA1c for children or adults.Network meta‐analysis for adults demonstrated that cognitive behavioural therapy (CBT) and attention control were associated with statistically and clinically significant HbA1c reduction.Psychological interventions are not indicated for improving glycaemic control for people with type 1 diabetes. For adults, CBT‐based interventions have the potential to be effective.

]]>
<![CDATA[Women's views on screening for Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for increasing uptake]]> https://www.researchpad.co/article/N7007d53d-7eb8-40f4-a7d4-f5e70032f746

Abstract

Aim

Many women do not attend recommended glucose testing following a pregnancy affected by gestational diabetes (GDM). We aimed to synthesize the literature regarding the views and experiences of women with a history of GDM on postpartum glucose testing, focusing on barriers and facilitators to attendance.

Methods

We systematically identified qualitative studies that examine women's experiences following GDM relating to glucose testing (diabetes screening) or experience of interventions to promote uptake of testing. We conducted a thematic synthesis to develop descriptive and then analytical themes, then developed recommendations to increase uptake based on the findings. We evaluated the quality of each study and the confidence that we had in the recommendations using published checklists.

Results

We included 16 articles after screening 23 160 citations and 129 full texts. We identified four themes of influences relating to the healthcare system and personal factors that affected both ability and motivation to attend: relationship with health care, logistics of appointments and tests, family‐related practicalities and concern about diabetes. We developed 10 recommendations addressing diabetes risk information and education, and changes to healthcare systems to promote increased attendance at screening in this population, most with high or moderate confidence.

Conclusions

We have identified a need to improve women's understanding about Type 2 diabetes and GDM, and to adjust healthcare provision during and after pregnancy to decrease barriers and increase motivation for testing. Encouraging higher uptake by incorporating these recommendations into practice will enable earlier management of diabetes and improve long‐term outcomes.

]]>