According to two systematic evidence reviews published in Annals of Internal Medicine, behavioral interventions offer limited improvements in glycemic control for patients with type 1 and type 2 diabetes. Such interventions did not seem to affect other health outcomes.
Type 1 diabetes
Type 1 diabetes is one of the most common chronic diseases in childhood and adolescents and is increasing in prevalence in the U.S. Intensive glycemic control has been proven to prevent diabetes-related health complications and death. Other factors, such as intensive lowering of blood pressure and diabetes-related stress management seem to improve outcomes, as well. Some data suggest that behavioral approaches for self-management programs benefit individuals with type 1 diabetes.
Researchers conducted a systematic review and meta-analysis of published research to determine the effects of behavioral programs for patients with type 1 diabetes on behavioral, clinical, and health outcomes and to investigate factors that might moderate the effect of such programs. They found that behavioral programs for type 1 diabetes offer some benefit for glycemic control, at least at short-term follow-up. The current evidence does not support encouraging patients with type 1 diabetes to participate in behavioral programs to improve outcomes except for glycemic control.
Type 2 diabetes
More than 29 million Americans suffer from type 2 diabetes. Tight glycemic control is important for reducing microvascular complications, as is management of body weight, blood pressure, and cholesterol levels. As such, patients with type 2 diabetes are advised to adhere to multiple self-care behaviors, including healthy eating, being active, taking medications, and healthy coping. Evidence suggests that behavioral interventions can help patients stick to their programs and achieve better health outcomes.
Researchers reviewed published evidence to identify factors that could improve the effectiveness of behavioral programs for adults with type 2 diabetes. They found that more intensive programs were more effective and worked better for patients with suboptimal glycemic control than for those with good control. Self-management education programs with 10 or fewer hours of contact with delivery personnel provided little benefit.