Talks matched to each person's readiness lowered blood sugar and improved self-care.

The review

1. 01

   Who took part

   4,214 adults with type 2 diabetes took part in 30 trials, mostly in China. Their average age ranged from about 41 to 75, and ten trials focused on people over 60.

2. 02

   What they did

   Nurses usually led the talks: one to 22 talks, about 30 minutes each, over three to 12 months. Each talk matched its advice to where the person was in changing, such as just thinking about it or already trying. The other group got usual care or standard teaching about diabetes.

3. 03

   What happened

   Compared with the other groups, the blood sugar test HbA1c fell more, by about 0.9 percentage points. Self-care and confidence also rose more than in the other groups, though the studies varied widely. The authors rate the HbA1c evidence as strong, and a check found signs that some results were not published.

What the review found

1. HelpedOther outcomes

   Across 24 studies, talks matched to readiness lowered HbA1c, a blood sugar test, more than usual care did.

   • Action: Talk through your mixed feelings about changingtested
   • Action: Set a specific goaltested
   • Rule: Use the method that fits youtested
   • Rule: With a coach or therapistused

   Pooled analysis of 24 studies · vs people who got usual care or standard teaching · the authors rated their certainty high · ⚠ whole programmes were tested, so no single part can be credited

2. HelpedOther outcomes

   Across 23 studies, talks matched to readiness lowered fasting blood sugar more than usual care did.

   • Action: Talk through your mixed feelings about changingtested
   • Action: Set a specific goaltested
   • Rule: Use the method that fits youtested
   • Rule: With a coach or therapistused

   Pooled analysis of 23 studies · vs people who got usual care or standard teaching · the authors rated their certainty moderate · ⚠ signs that small negative studies went unpublished; results look too good to be true; the studies disagreed a lot; whole programmes were tested, so no single part can be credited

3. HelpedGoals

   Across 11 studies, people said they did more self-care after talks than after usual care.

   • Action: Talk through your mixed feelings about changingtested
   • Action: Set a specific goaltested
   • Rule: Use the method that fits youtested
   • Rule: With a coach or therapistused

   Pooled analysis of 11 studies · vs people who got usual care or standard teaching · they rated themselves · ⚠ results look too good to be true; the studies disagreed a lot; whole programmes were tested, so no single part can be credited

4. HelpedMotivation

   Across seven studies, people felt more sure of themselves after talks than after usual care.

   • Action: Talk through your mixed feelings about changingtested
   • Action: Set a specific goaltested
   • Rule: Use the method that fits youtested
   • Rule: With a coach or therapistused

   Pooled analysis of 7 studies · vs people who got usual care or standard teaching · they rated themselves · ⚠ results look too good to be true; the studies disagreed a lot; whole programmes were tested, so no single part can be credited

Source