A Cochrane review [Abstract] 1 included 33 studies with a total of 7453 subjects. 28 trials provided suitable data for entry into meta-analysis. Glycaemic control (HbA1c), showed an improvement following culturally appropriate health education at three months (WMD - 0.4%, 95% CI -0.5 to -0.02; 14 trials, n=1442), and at six months (WMD -0.5%, 95% CI -0.7 to -0.4; 14 trials, n=1972), compared with control groups who received 'usual care'. This effect was sustained to a lesser extent at 12 months (WMD -0.2%, 95% CI -0.3 to 0.4; 9 trials, n=1936) and at 24 months (MD -0.3% (95% CI -0.6 to -0.1; 4 trials; 2268 participants) post intervention. Knowledge scores also improved in the intervention groups at three months (SMD 0.4, 95% CI 0.1 to 0.6), and twelve months (SMD 0.4, 95% CI 0.1 to 0.6) post intervention. A reduction in triglycerides of 24 mg/dL was observed at three months, but this was not sustained at six or 12 months. Other outcome measures both clinical (such as lipid levels, and blood pressure) and patient centred (quality of life measures, attitude scores and measures of patient empowerment and self-efficacy) showed neutral effects.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by inconsistency (heterogeneity in interventions and outcomes).
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