Effectiveness of Educational and Psychoeducational Self‐Management Interventions in Children and Adolescents With Type 1 Diabetes: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
Aim: Type 1 diabetes (T1D) is one of the most common chronic conditions in children and adolescents. Approximately 1.5 million young people are currently living with T1D throughout the world. Despite recent improvement in overall indices of metabolic control in children and adolescents with T1D, control remains suboptimal and additional approaches are needed. The aim of the study was to conduct a systematic review and meta‐analysis of educational and psychoeducational self‐management interventions, to help optimize future interventions including physical activity support. Methods: A systematic review and meta‐analysis were conducted according to our registered protocol (PROSPERO CRD42022295932) and are reported in line with the PRISMA 2020 guidance. We searched five databases (MEDLINE, EMBASE, PsycINFO [via Ovid], CINAHL [via EBSCO], Cochrane Library) from 1994 up to May 2024. We included randomized controlled trials assessing the effectiveness of self‐management interventions. Outcomes of interest included HbA1c and quality of life (QoL) as well as self‐care behaviors, diabetes knowledge, and self‐efficacy. Meta‐analyses were conducted using a random effects model. Results: In total, 46 papers were included, reporting on 30 interventions. Meta‐analyses showed small short‐term improvements in HbA1c (MD = −2.58 mmol/L, 95% CI −4.44 to −0.71, p = 0.007) and QoL (mean difference [MD] = 1.37, 95% CI 0.19–2.54, p = 0.02). Prespecified subgroup analyses suggested no significant difference in effectiveness of psychoeducational and education‐only interventions. Quality of included studies was low with 27 having a high risk of bias. Conclusion: There is a lack of robust evidence that current self‐management interventions result in clinically meaningful improvements in HbA1c and QoL. Future research should focus on redefining approaches to supporting and encouraging self‐management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.036 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".