Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Search Strategy, and Information Sources
2.2. Study Selection
2.3. Data Extraction and Risk of Bias within Individual Studies
2.4. Statistical Analysis
3. Results
3.1. Type of Intervention
3.2. Risk of Bias
3.3. Odds Ratio with Onset of Type 2 Diabetes
4. Discussion
4.1. Findings in the Context of the Literature
4.2. Strengths and Limitations
4.3. Implications for Practice and Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Interventions | Pair-Wise | NMA (Frequentist Approach) (r = 0.5) | NMA (Bayesian Approach) $ | ||
---|---|---|---|---|---|
n# | OR (95% CI) | I2 | OR (95% CI) | OR (95% CI) | |
Comparison for Lifestyle | |||||
Lifestyle vs. Exercise (indirect) | 1.18 (0.74,1.93) | 1.57 (0.81,3.28) | |||
Lifestyle vs. Diet (indirect) | 0.93 (0.60,1.43) | 1.01 (0.53,1.94) | |||
Lifestylevs. Orlistat (indirect) | 1.19 (0.55,2.58) | 1.01 (0.37,2.77) | |||
Lifestyle vs. Acarbose/Voglibose (indirect) | 0.92 (0.57,1.48) | 0.89 (0.44,1.84) | |||
Lifestyle vs. Metformin/Flumamine (indirect) | 0.86 (0.60,1.25) | 0.96 (0.58,1.73) | |||
Lifestyle vs. Pioglitazone, Rosiglitazone (indirect) | 0.57 (0.32,1.00) | 0.57 (0.26,1.36) | |||
Lifestyle vs. Pitavastatin (indirect) | 0.68 (0.36,1.29) | 0.53 (0.20,1.37) | |||
Lifestyle vs. Glipizide (indirect) | 2.07 (0.24,17.7) | 3.21 (0.31,99.3) | |||
Lifestyle vs. Herbal medicine (indirect) | 0.71 (0.38,1.36) | 0.73 (0.29,1.87) | |||
Lifestyle vs. Standard | 19 | 0.65 (0.56,0.75) | 4.7 | 0.60 (0.48,0.76) | 0.46 (0.33,0.61) |
Lifestyle vs. Placebo | 1 | 0.44 (0.31,0.61) | 0.41 (0.27,0.63) | 0.38 (0.20,0.71) | |
Comparison for Lifestyle | |||||
Diet vs. Standard | 4 | 0.71 (0.55,0.90) | 35.7 | 0.65 (0.43,0.98) | 0.46 (0.24,0.84) |
Exercise vs. Standard | 4 | 0.45 (0.24,0.84) | 29.9 | 0.50 (0.31,0.81) | 0.29 (0.14,0.55) |
Orlistat vs. Standard | 1 | 0.49 (0.25,0.95) | 0.51 (0.24,1.07) | 0.45 (0.17,1.19) | |
Acarbose/Voglibose vs. Standard | 2 | 0.70 (0.31,1.57) | 13.4 | 0.66 (0.42,1.04) | 0.51 (0.25,0.99) |
Metformin/Flumamine vs. Standard | 3 | 0.40 (0.10,1.68) | 75.4 | 0.70 (0.47,1.03) | 0.48 (0.26,0.79) |
Pioglitazone, Rosiglitazone vs. Standard (indirect) | 1.06 (0.60,1.90) | 0.80 (0.33,1.76) | |||
Pitavastatin vs. Standard | 1 | 0.88 (0.65,1.20) | 0.88 (0.49,1.59) | 0.87 (0.34,2.17) | |
Glipizide vs. Standard (indirect) | 0.29 (0.03,2.51) | 0.14 (0.00,1.45) | |||
Herbal medicine vs. Standard (indirect) | 0.85 (0.44,1.61) | 0.63 (0.24,1.58) | |||
Placebo vs. Standard (indirect) | 1.46 (0.95,2.25) | 1.23 (0.63,2.23) | |||
Comparison with Placebo | |||||
Diet vs. Placebo (indirect) | 0.45 (0.25,0.79) | 0.37 (0.16,0.89) | |||
Exercise vs. Placebo (indirect) | 0.35(0.19,0.64) | 0.38 (0.16,0.88) | |||
Orlistat vs. Placebo | 1 | 0.40 (0.07,2.24) | 0.35 (0.15,0.79) | 0.35 (0.14,0.90) | |
Acarbose/Voglibose vs. Placebo | 1 | 0.38 (0.25,0.58) | 0.45 (0.28,0.74) | 0.42 (0.20,0.87) | |
Metformin/Flumamine vs Placebo | 3 | 0.52 (0.30,0.91) | 64.4 | 0.48 (0.32,0.71) | 0.39 (0.21,0.67) |
Pioglitazone, Rosiglitazone vs. Placebo | 3 | 0.70 (0.44,1.11) | 87.3 | 0.73 (0.50,1.05) | 0.65 (0.37,1.11) |
Pitavastatin vs. Placebo (indirect) | 0.64 (0.29,1.42) | 0.71 (0.24,2.23) | |||
Glipizide vs. Placebo | 1 | 0.22 (0.02,1.90) | 0.20 (0.02,1.64) | 0.12 (0.00,1.13) | |
Herbal medicine vs. Placebo | 3 | 0.60 (0.45,0.82) | 0.0 | 0.60 (0.29,1.26) | 0.51 (0.25,1.02) |
Log Likelihood Ratio/p-values for inconsistency | χ2 = 7.24, p = 0.78 (df = 11) | Tau = 0.42 (0.23,0.66) |
Study rank | Lifestyle | Exercise | Diet | Orlistat | Acarbose/Voglibose | Metformin/Flumamine | Pioglitazone/Rosiglitazone | Pitavastatin | Glipizide | Herbal medicine | Placebo | Standard |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Worst | 0.0 | 0.0 | 0.1 | 0.4 | 0.0 | 0.0 | 4.1 | 8.0 | 6.7 | 1.3 | 77.0 | 2.5 |
Mean | 4.4 | 3.1 | 5.4 | 3.6 | 5.4 | 6.0 | 9.6 | 8.2 | 3.0 | 7.7 | 11.7 | 9.5 |
SUCRA | 0.7 | 0.8 | 0.6 | 0.8 | 0.6 | 0.5 | 0.2 | 0.3 | 0.8 | 0.4 | 0.0 | 0.2 |
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Yamaoka, K.; Nemoto, A.; Tango, T. Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis. Nutrients 2019, 11, 1373. https://doi.org/10.3390/nu11061373
Yamaoka K, Nemoto A, Tango T. Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis. Nutrients. 2019; 11(6):1373. https://doi.org/10.3390/nu11061373
Chicago/Turabian StyleYamaoka, Kazue, Asuka Nemoto, and Toshiro Tango. 2019. "Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis" Nutrients 11, no. 6: 1373. https://doi.org/10.3390/nu11061373
APA StyleYamaoka, K., Nemoto, A., & Tango, T. (2019). Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis. Nutrients, 11(6), 1373. https://doi.org/10.3390/nu11061373