Efficacy of non-pharmacological interventions in controlling type 2 diabetes in patients of African descent: A systematic review

Abstract

Purpose: The purpose of this review is to systemati-cally assess the potential effectiveness of targeted educational and other non-pharmacological interven-tions on diabetes control in populations of African descent in developed countries. Such information can inform intervention strategies and highlight evidence-based approaches to deal with this significant prob-lem in this population. Methods: A systematic review and a meta-analysis of random controlled trials and cohort studies evaluating the influence of education and other non-pharmacological interventions on HbA1C concentrations in patients of African descent with diabetes. A comprehensive search of PubMed, EMBASE, CINAHL, ZETOC, SIGLE databases was carried out. Results: Although nine studies (8 ran-domised controlled trials and 1 cohort study) met the inclusion criteria, relevant HbA1C data were avail-able for 6 of the studies for the subsequent meta-analysis. Heterogeneity of meta-analysis was high (I 2 = 92%), the random effects pooled standard mean difference favoured the intervention −0.66 (−1.15, −0.17), p = 0.009. After sensitivity analysis, I 2 re-mained moderate to high at 69%. The random effects pooled standard mean difference continued to favour the intervention −0.48 (−0.81, −0.16), p = 0.009. Con-clusion: There is evidence supporting the efficacy of educational and other non-pharmacological interven-tions in diabetes control in populations of African descent in English speaking developed countries. This conclusion is tempered by the significant heterogene-ity of selected interventions and paucity of high qual-ity research in the target population.