J Clin Nurs. 2025 May 14. doi: 10.1111/jocn.17782. Online ahead of print.
ABSTRACT
AIMS AND OBJECTIVE: To evaluate the effects of dietary intervention and the commonly used behaviour change techniques (BCTs) on clinical outcomes in patients with T2DM.
BACKGROUND: Effective dietary management is crucial in the management of diabetes. Behavioural change strategies are important in improving dietary adherence, but limited understanding of available evidence currently exists.
DESIGN: A systematic review and meta analysis using the PRISMA checklist were used to synthesise the evidence.
METHODS: Systematic review of five databases was completed using selected key terms. Meta-analysis was conducted to test the effects of the dietary interventions and to identify effective BCTs.
RESULTS: Nine studies were included in this research. Overall, the dietary interventions showed significant HbA1c reduction, with merits from personalised dietary interventions tailored to patient characteristics. Meanwhile, there was a sustained reduction in HbA1c after three, six, and twelve months post intervention. Moreover, significant improvements in weight and lipid profile were observed by the sixth month. Regarding employed BCTs, 'Credible Source' and'Conserving Mental Resources' were deemed to be both clinically and statistically significant in reducing HbA1c (> 0.3%), while 14 other BCTs were identified as being associated with a clinically meaningful reduction in HbA1c (> 0.3%).
CONCLUSION: Comprehensive dietary interventions incorporating selective BCTs significantly improved HbA1c, weight, and lipid profiles in patients with T2DM. Identified BCTs and the commonly used intervention features tailored to patient characteristics were most effective in dietary behaviour interventions.
RELEVANCE TO CLINICAL PRACTICE: It is suggested that, besides the commonly used BCTs (e.g., 'Goals and Planning' and 'Feedback on Behavior'), the application of 'Conserving Mental Resources' and ensuring 'Credible Source' should be incorporated into dietary interventions for patients with T2DM in clinical practice.
PATIENT OR PUBLIC CONTRIBUTION: The is no patient or public contribution in this paper.
TRIAL REGISTRATION: This study was registered at the International Prospective Register of Systematic Reviews.
PROSPERO ID: CRD42023459274.
PMID:40369662 | DOI:10.1111/jocn.17782