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Effectiveness of non-pharmacological interventions on metabolic control in adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials.

Created on 12 Sep 2026

Authors

Tran Thi My, Nantiya Watthayu

Published in

Diabetes research and clinical practice. Pages 113556. Sep 11, 2026. Epub Sep 11, 2026.

Abstract

This systematic review and meta-analysis evaluated the effectiveness of non-pharmacological interventions in improving MetS-related metabolic-control outcomes among adults with type 2 diabetes mellitus. PubMed, Scopus, ScienceDirect, and the Cochrane Library were searched from January 2005 to June 2025. Eligible randomised controlled trials compared non-pharmacological interventions with usual care, standard care, or no intervention and reported at least three prespecified metabolic syndrome components. Non-randomised studies and pharmacological, surgical, medical-device, supplement-based, or insufficiently reported interventions were excluded. Random-effects models used restricted maximum-likelihood estimation with the Knapp-Hartung adjustment, and risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Forty-two trials involving 9,586 participants were included. Interventions significantly reduced glycated haemoglobin (HbA1c; mean difference [MD] -0.43 percentage points, 95% confidence interval [CI] -0.55 to -0.32), fasting glucose (MD -0.57 mmol/L, 95% CI -0.83 to -0.32), waist circumference (MD -2.25 cm, 95% CI -3.32 to -1.19), systolic blood pressure (MD -1.66 mmHg, 95% CI -2.98 to -0.34), and diastolic blood pressure (MD -0.93 mmHg, 95% CI -1.56 to -0.30), but not triglycerides or high-density lipoprotein cholesterol. Continuous meta-regression showed no significant duration effect. Non-pharmacological interventions provide modest cardiometabolic benefits, although heterogeneity and possible small-study effects warrant caution. Registration: PROSPERO CRD420251073643.

PMID:
42727859
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

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