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Effectiveness of strategies in primary health care in the management of type 2 Diabetes: a systematic review network meta-analysis

Grant number: 18/25035-5
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Start date: April 01, 2019
End date: September 30, 2021
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Vania dos Santos Nunes Nogueira
Grantee:Luísa Rocco Banzato
Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Introduction: despite the vast number of medications currently available for the treatment of type 2 diabetes (DM2), and the many public guidelines on its management, a large number of patients remains with the disease uncontrolled. Some studies have shown that less than 10% of the affected individuals have controlled the disease according to the proposed recommendations. The most relevant risk factor regarding DM2 complications is an inadequate glycemic control. Objective: evaluate the effectiveness of strategies in primary health care that aim a greater engagement of patients on their treatment and DM2 control. Methods: we will perform a systematic review according to Cochrane collaboration, and a network meta-analysis with the MTC method (Mixed Treatment Comparisons). We will included randomized studies, in which patients with DM2 were allocated to strategies that increased their engagement in the treatment of their disease (intervention) or subjected to standard treatment (medical appointments and general recommendations on lifestyle changes) (control). The primary outcomes that will be analyzed are quality of life, the patient's satisfaction with the treatment, glycemic control and the control of hypertension and dyslipidemia, frequency of cardiac event and deaths. The secondary outcomes analyzed will be: weight loss (evaluate through final weight or waist circumference or body mass index (BMI), number of patients in each group with HbA1c <6.5, number of patients in each group with HA1c <7, average difference of HbA1c between control and intervention at 3, 6, 12, 18 and 24 months. Change of the HbA1c from the first and last visitation, need of inpatient care due to acute or chronic complications of DM, and cost.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
GALENDI, JULIA SIMOES CORREA; OCCHIUTO FERREIRA LEITE, RENATA GIACOMINI; BANZATO, LUISA ROCCO; NUNES-NOGUEIRA, VANIA DOS SANTOS. Effectiveness of Strategies for Nutritional Therapy for Patients with Type 2 Diabetes and/or Hypertension in Primary Care: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, v. 19, n. 7, p. 21-pg., . (18/25035-5)
LEITE, RENATA GIACOMINI OLIVEIRA FERREIRA; BANZATO, LUISA ROCCO; GALENDI, JULIA SIMOES CORREA; MENDES, ADRIANA LUCIA; BOLFI, FERNANDA; VERONIKI, ARETI ANGELIKI; THABANE, LEHANA; NUNES-NOGUEIRA, VANIA DOS SANTOS. Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis. BMJ OPEN, v. 10, n. 1, . (18/25035-5)