Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis

Muñoz Pardeza, Jacinto; López Gil, José Francisco; Huerta Uribe, Nidia; Hormazábal Aguayo, Ignacio; Izquierdo Redín, Mikel; García Hermoso, Antonio

Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis

dc.contributor.author	Muñoz Pardeza, Jacinto
dc.contributor.author	López Gil, José Francisco
dc.contributor.author	Huerta Uribe, Nidia
dc.contributor.author	Hormazábal Aguayo, Ignacio
dc.contributor.author	Izquierdo Redín, Mikel
dc.contributor.author	García Hermoso, Antonio
dc.contributor.department	Ciencias de la Salud	es_ES
dc.contributor.department	Osasun Zientziak	eu
dc.date.accessioned	2024-10-16T17:02:16Z
dc.date.available	2024-10-16T17:02:16Z
dc.date.issued	2024-07-01
dc.date.updated	2024-10-16T16:39:31Z
dc.description.abstract	The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine which interventions could provide the most significant benefits for the metabolic health of young individuals with type 1 diabetes mellitus. The aim of this study was to identify optimal nonpharmacological interventions on glycaemic control, measured by glycated haemoglobin (HbA1c), in children and adolescents with type 1 diabetes. Systematic searches were conducted in PubMed, Web of Science, Scopus, and SPORTDiscus from inception to July 1, 2023. Randomised clinical trials (RCT) investigating nonpharmacological interventions (e.g., physical activity, nutrition, and behavioural therapies) were included. Primary outcome was change in HbA1c levels. Secondary outcome was change in daily insulin dose requirement. Seventy-four RCT with 6,815 participants (49.43% girls) involving 20 interventions were analysed using a network meta-analysis. Most interventions showed greater efficacy than standard care. However, multicomponent exercise, which includes aerobic and strength training (n = 214, standardised mean difference [SMD] =– 0.63, 95% credible interval [95% CrI] – 1.09 to – 0.16) and nutritional supplements (n = 146, SMD =– 0.49, – 0 .92 to – 0.07) demonstrated the greatest HbA1c reductions. These interventions also led to the larger decreases in daily insulin needs (n = 119, SMD =– 0.79, 95% CrI – 1.19 to – 0.34) and (n = 57, SMD =– 0.62, 95% CrI – 1.18 to – 0.12, respectively). The current study underscores non-pharmacological options such as multicomponent exercise and nutritional supplements, showcasing their potential to significantly improve HbA1c in youth with type 1 diabetes. Although additional research to confirm their efficacy is required, these approaches could be considered as potential adjuvant therapeutic options in the management of type 1 diabetes among children and adolescents.	en
dc.description.sponsorship	This study was funded by grant PI21/01238 from the Instituto de Salud Carlos III (Spain). The project that gave rise to these results received the support of a fellowship form “Instituto de Salud Carlos III” granted to Jacinto Muñoz-Pardeza (FI22/00329). The project that gave rise to these results received the support of a fellowship from “la Caixa” Foundation granted to Nidia Huerta Uribe (ID 11780038).
dc.format.mimetype	application/pdf	en
dc.format.mimetype	application/msword	en
dc.identifier.citation	Muñoz-Pardeza, J., López-Gil, J. F., Huerta-Uribe, N., Hormazábal-Aguayo, I., Izquierdo, M., García-Hermoso, A. (2024) Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis. Cardiovascular Diabetology, 23(1), 1-12. https://doi.org/10.1186/s12933-024-02301-3.
dc.identifier.doi	10.1186/s12933-024-02301-3
dc.identifier.issn	1475-2840
dc.identifier.uri	https://academica-e.unavarra.es/handle/2454/52303
dc.language.iso	eng
dc.publisher	BMC
dc.relation.ispartof	Cardiovascular Diabetology 23:230 (2024)
dc.relation.projectID	info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI21%2F01238/ES/
dc.relation.publisherversion	https://doi.org/10.1186/s12933-024-02301-3
dc.rights	© The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License.
dc.rights.accessRights	info:eu-repo/semantics/openAccess
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/
dc.subject	Adolescence	en
dc.subject	Childhood	en
dc.subject	Diet	en
dc.subject	Exercise	en
dc.subject	Glucose	en
dc.subject	Glycosylated haemoglobin	en
dc.subject	Insulin	en
dc.subject	Intervention	en
dc.subject	Lifestyle	en
dc.subject	Nonpharmacological	en
dc.title	Nonpharmacological interventions on glycated haemoglobin in youth with type 1 diabetes: a Bayesian network meta-analysis	en
dc.type	info:eu-repo/semantics/article
dc.type.version	info:eu-repo/semantics/publishedVersion
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