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Transtheoretical Model-based Dietary and Exercise Interventions for Glycemic Control in Type 2 Diabetes: Systematic
Vanessa M Menezes1, Olívia G Koller1, Ana Maria P Feoli2
1Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90035-003, Brazil.
Transtheoretical Model of Change interventions improved glycemic control in type 2 diabetes patients. Further high-quality trials are needed due to limited evidence certainty and methodological concerns.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Behavioral Medicine
Background:
- Diabetes management involves lifestyle changes and pharmacotherapy.
- The Transtheoretical Model of Change (TTMC) offers a framework for behavioral interventions.
- Systematic evaluation of TTMC-based interventions in type 2 diabetes is necessary.
Purpose of the Study:
- To systematically review the impact of TTMC-based diet and/or exercise interventions.
- To assess effects on glycemic control, body weight, and glucose-lowering medications.
- To evaluate interventions in adults with type 2 diabetes.
Main Methods:
- Searched major databases (PubMed, Web of Science, Embase, Scopus, PsycInfo) through June 2024.
- Included randomized controlled trials (RCTs) of adults with type 2 diabetes.
- Assessed study quality using the Cochrane Risk of Bias tool.
Main Results:
- Twelve RCTs (n=2484) were included, with interventions focusing on diet, exercise, or both.
- TTMC interventions significantly reduced glycated hemoglobin by 0.73% compared to usual care.
- Meta-analysis for body weight and medication use was not feasible due to limited data.
Conclusions:
- TTMC-based interventions show a positive effect on glycemic control in type 2 diabetes.
- Evidence certainty is very low, necessitating caution in interpretation.
- High-quality, well-designed future trials are crucial to confirm these findings.
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