Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis.
Sharon A Brown, Alexandra A García, Adama Brown and 7 others
PMID 27036083WHAT IT FOUND
For people with type 2 diabetes, dietary adherence was most linked to long-term glucose control, self-efficacy was linked to adherence and BMI, and glucose monitoring was linked to higher short-term glucose.
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Key findings
01Dietary adherence had a standardized effect of beta = -0.16 on HbA1c, larger than physical activity adherence at beta = -0.06.
02Self-efficacy and coping had the strongest relationships with dietary adherence, with self-efficacy at r = 0.34.
03For fasting glucose, glucose self-monitoring was a significant predictor, and higher monitoring was associated with higher fasting glucose.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
All primary studies were cross-sectional, so the review shows associations, not cause. The mean study quality score was low (2.8 on a 0 to 10 scale). Many studies lacked data on socio-economic or educational level. 31% of correlations were computed from other association data. The median sample size was 147, which may give low power for small correlations. Attrition was about 11% across studies, which the authors note could matter for small samples. Predictors varied by outcome and model, so no single variable fits all goals.
Declared interests
The authors declare no actual or potential conflicts of interest.
The easy way to misread this
Do not read these links as proof that improving self-efficacy, coping, or dietary adherence will lower HbA1c. The review combined cross-sectional association studies, so it cannot establish cause.