Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

POSTER DISCUSSION: A systematic review and meta analysis of lifestyle interventions to prevent and manage type 2 diabetes in pacific communities (#344)

Dorothy Ndwiga 1 , Freya MacMillan 1 , Kate McBride 1 , David Simmons 1
  1. Western Sydney University, Sydney, NSW, Australia

Background

Pacific communities are among the largest culturally and linguistically diverse (CALD) populations in Australia and have a high prevalence of type 2 diabetes and obesity. Studies show that culturally tailored lifestyle interventions can significantly reduce HbA1c and weight. This review aimed to conduct a systematic review and meta-analysis on the effectiveness of lifestyle interventions in the prevention and management of type 2 diabetes in Pacific communities. 

 

Methods                                               

MEDLINE, Web of Science and EMBASE databases were searched for studies published up to April 2017. All authors reviewed the search strategy and assessed for risk of bias of included studies. Randomised control trials or pre-post design studies, focusing on diet and/or physical activity (≥ 3 months) in Pacific People (≥18 years) with or at risk of type 2 diabetes, were included. RevMan 5 software was utilised for meta-analysis on HbA1c and weight as the health outcome measures.

 

Findings

The search strategy retrieved 911 citations. Studies were excluded if participants were from different or mixed populations. Eight studies were included in the systematic review while six were included in the meta-analysis. Two focused on diabetes management and six on diabetes prevention. Meta-analysis revealed that the interventions resulted in a reduction in HbA1c (%) [WMD = -0.19% (95% Cl = -0.54 to -0.15)] and reduction in weight (%) [WMD = -0.05% (95% Cl = -0.30 to -0.20)] across two and four included studies respectively (Fig 1). Other health outcomes improved including blood pressure and waist circumference.

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Conclusion

Although standard RCTs have shown diabetes can be prevented and diabetes management improved, translation into CALD communities is limited. Insufficient evidence currently exists that culturally tailored community-based lifestyle interventions are effective. Further studies are needed to develop and test such interventions.

 

 

  1. Ravulo J. Pacific communities in Australia report. University of Western Sydney 2015