Effectiveness of an educational intervention on the components of the metabolic syndrome of adults with type 2 diabetes: non-randomized clinical trial.

The groups were not randomly assigned, and participants were not blinded, so selection and expectation effects cannot be ruled out. The analysed sample was small (51 adults), and the authors did not stratify by sex because of sample size. Attrition was substantial: 108 volunteers were recruited, 70 were considered, and 9 intervention participants and 10 control participants were excluded. The intervention was multidisciplinary and delivered many components together, so the effect of any single component, including nurse-led delivery, cannot be separated. Follow-up was only six months, and several MetS markers did not change significantly. The paper does not explicitly name one primary outcome; it reports changes across several metabolic syndrome components. The paper states that no statistically significant difference was detected between groups, while also reporting significant time-by-group interactions for glucose, HDL-c, and MetS score; the reader cannot tell which comparison is primary.

The supplied text reports funding by the Research Support Foundation of the State of Bahia (FAPESP, process number BOL0549/2019). No other conflict-of-interest statement is given.

Do not conclude that nurse-led education alone caused the metabolic improvements. The program also included general MetS information, individual risk feedback, nurse-led workshops, invited health professional topics, nutrition, psychology, physical activity demonstrations, integrative nursing practices, physical therapy, pharmacy, and cardiology content, so the contribution of any single component cannot be separated. Also, only 11.5% (n = 3) no longer met MetS criteria at the end.