Cochrane · systematic review · CD003054
Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus
Hemmingsen, B, Gimenez‐Perez, G, Mauricio, D, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
17
No studies
4
Included studies
NR
No studies 4 · 19%Ungraded 0 · 0%Very low 13 · 61.9%Low 3 · 14.3%Moderate 1 · 4.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Diet plus physical activity versus standard treatment
Population: people at increased risk of developing type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Diet plus physical activity vs standard treatment | RR 1.12 [0.5, 2.5] | 10 studies · 4099 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Incidence of type 2 diabetes mellitus Diagnostic criteria: 3 trials applied the WHO 1985 criteria (FPG ≥ 7.8 mmol/L or a 2‐hour glucose ≥ 11.1 mmol/L after a 75 g OGTT) (Da Qing 1997; DPS 2001; Oldroyd 2005). 3 trials applied the WHO 1999 criteria... Diet plus physical activity vs standard treatment | RR 0.57 [0.5, 0.64] | 11 studies · 4511 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Serious adverse events (SAE) Diet plus physical activity vs standard treatment | no estimate extracted | 2 studies · 250 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Cardiovascular mortality Diet plus physical activity vs standard treatment | RR 0.94 [0.24, 3.65] | 7 studies · 3263 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Non‐fatal myocardial infarction/stroke Diet plus physical activity vs standard treatment | no estimate extracted | 1 study · 102 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Health‐related quality of life Description: SF‐36 to evaluate the SF‐6D, PCS and MCS MID was defined as difference in scores between groups of at least 3% Diet plus physical activity vs standard treatment | no estimate extracted | 1 study · 2144 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Socioeconomic effects Description: direct medical costs of the interventions Diet plus physical activity vs standard treatment | no estimate extracted | 4 studies · 2775 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Diet versus physical activity or standard treatment
Population: people at increased risk of developing type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Diet vs physical activity or standard treatment | no estimate extracted | 1 study · 530 participants | Very low Downgraded: imprecision |
Incidence of type 2 diabetes mellitus Definition: WHO 1985 criteria Diet vs physical activity or standard treatment | no estimate extracted | 1 study · 530 participants | Very low Downgraded: imprecision |
Serious adverse events Diet vs physical activity or standard treatment | no estimate extracted | 1 study · 530 participants | Very low Downgraded: imprecision |
Cardiovascular mortality Diet vs physical activity or standard treatment | no estimate extracted | 1 study · 530 participants | Very low Downgraded: imprecision |
Non‐fatal myocardial infarction/stroke Diet vs physical activity or standard treatment | no estimate extracted | NR | No studies |
Health‐related quality of life Diet vs physical activity or standard treatment | no estimate extracted | NR | No studies |
Socioeconomic effects Diet vs physical activity or standard treatment | no estimate extracted | NR | No studies |
Physical activity versus standard treatment
Population: people at increased risk of developing type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Physical activity vs standard treatment | no estimate extracted | 2 studies · 397 participants | Very low Downgraded: imprecision |
Incidence of type 2 diabetes mellitus Definition: 1 trial: FPG ≥ 7.8 mmol/L or a 2‐hour plasma glucose ≥ 11.1 mmol/L after a 75 g OGTT (Da Qing 1997). 1 trial FPG > 6.9 mmol/L and/or 2‐hour plasma glucose concentration > 12.1 mmol/L (Hellgren 2016) Physical activity vs standard treatment | no estimate extracted | 2 studies · 397 participants | Very low Downgraded: imprecision |
Serious adverse events Physical activity vs standard treatment | no estimate extracted | 2 studies · 397 participants | Very low Downgraded: imprecision |
Cardiovascular mortality Physical activity vs standard treatment | no estimate extracted | 1 study · 274 participants | Very low Downgraded: imprecision |
Non‐fatal myocardial infarction/stroke Description: non‐fatal myocardial infarction/stroke Physical activity vs standard treatment | no estimate extracted | 1 study · 123 participants | Very low Downgraded: imprecision |
Health‐related quality of life Definition: measured by two questions (grading total physical and mental health from 1 to 7; grading general health from 1 (best) to 5 (very bad)) Physical activity vs standard treatment | no estimate extracted | 1 study · 123 participants | Very low Downgraded: imprecision |
Socioeconomic effects Physical activity vs standard treatment | no estimate extracted | NR | No studies |