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Stevens JW, Khunti K, Harvey R, et al. Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions. Diabetes Res Clin Pract. 2015;107(3):320-31doi: 10.1016/j.diabres.2015.01.027.
Stevens, J. W., Khunti, K., Harvey, R., Johnson, M., Preston, L., Woods, H. B., Davies, M., & Goyder, E. (2015). Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions. Diabetes research and clinical practice, 107(3), 320-31. https://doi.org/10.1016/j.diabres.2015.01.027
Stevens, John W, et al. "Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions." Diabetes research and clinical practice vol. 107,3 (2015): 320-31. doi: https://doi.org/10.1016/j.diabres.2015.01.027
Stevens JW, Khunti K, Harvey R, Johnson M, Preston L, Woods HB, Davies M, Goyder E. Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions. Diabetes Res Clin Pract. 2015 Mar;107(3):320-31. doi: 10.1016/j.diabres.2015.01.027. Epub 2015 Jan 21. PMID: 25638454.
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Diabetes Res Clin Pract. 2015 Mar;107(3):320-31. doi: 10.1016/j.diabres.2015.01.027. Epub 2015 Jan 21.

Preventing the progression to type 2 diabetes mellitus in adults at high risk: a systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions.

Diabetes research and clinical practice

John W Stevens, Kamlesh Khunti, Rebecca Harvey, Maxine Johnson, Louise Preston, Helen Buckley Woods, Melanie Davies, Elizabeth Goyder

Affiliations

  1. University of Sheffield, UK. Electronic address: [email protected].
  2. University of Leicester, UK.
  3. University of Sheffield, UK.

PMID: 25638454 DOI: 10.1016/j.diabres.2015.01.027

Abstract

AIMS: Individuals with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) have an increased risk of progression to Type 2 diabetes mellitus. The objective of this review was to quantify the effectiveness of lifestyle, pharmacological and surgical interventions in reducing the progression to Type 2 diabetes mellitus in people with IFG or IGT.

METHODS: A systematic review was carried out. A network meta-analysis (NMA) of log-hazard ratios was performed. Results are presented as hazard ratios and the probabilities of treatment rankings.

RESULTS: 30 studies were included in the NMA. There was a reduced hazard of progression to Type 2 diabetes mellitus associated with all interventions versus standard lifestyle advice; glipizide, diet plus pioglitazone, diet plus exercise plus metformin plus rosiglitazone, diet plus exercise plus orlistat, diet plus exercise plus pedometer, rosiglitazone, orlistat and diet plus exercise plus voglibose produced the greatest effects.

CONCLUSIONS: Lifestyle and some pharmacological interventions are beneficial in reducing the risk of progression to Type 2 diabetes mellitus. Lifestyle interventions require significant behaviour changes that may be achieved through incentives such as the use of pedometers. Adverse events and cost of pharmacological interventions should be taken into account when considering potential risks and benefits.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Keywords: Mixed treatment comparison; Network meta-analysis; Systematic review; Type 2 diabetes mellitus

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