Self-management with goals and feedback may help adults cut blood sugar

The review

1. 01

   Who took part

   3,545 adults with poorly controlled type 2 diabetes took part in 16 trials. In each trial, the average age was 51 to 64, and in six trials most people were from ethnic minority groups.

2. 02

   What they did

   The programmes used goals, feedback, problem-solving and action plans. The comparison groups were usual care, teaching alone, a placebo or a group that started later.

3. 03

   What happened

   The blood sugar test (HbA1c) fell by about 0.4 more than in other groups, but the drop faded after about a year. Self-care actions showed no clear change, while confidence rose and stress fell. The paper's quality-of-life numbers don't agree, so we can't give a result.

What the review found

1. HelpedOther outcomes

   Across 16 trials, programmes with goals, feedback and planning lowered blood sugar more than others did.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Get feedback on your progresstested
   • Rule: Write down when and wheretested

   Pooled analysis of 16 studies with 3,545 people · vs people who got usual care or other treatment · ⚠ the studies disagreed a lot; whole programmes were tested, so no single part can be credited

2. No differenceGoals

   Across 5 studies, these programmes made no clear difference to self-care actions.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Get feedback on your progresstested
   • Rule: Write down when and wheretested

   Pooled analysis of 5 studies with 656 people · vs people who got usual care or other treatment · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

3. HelpedMotivation

   Across 3 studies, these programmes made people more sure of managing their diabetes.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Get feedback on your progresstested
   • Rule: Write down when and wheretested

   Pooled analysis of 3 studies with 533 people · vs people who got usual care or other treatment · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

4. HelpedOther outcomes

   Across 2 studies, these programmes left people less stressed about diabetes.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Get feedback on your progresstested
   • Rule: Write down when and wheretested

   Pooled analysis of 2 studies with 506 people · vs people who got usual care or other treatment · they rated themselves · ⚠ whole programmes were tested, so no single part can be credited

Source