InterpretationĤ) Evaluation: randomised controlled trials (RCTs) with an active intervention arm compared to a comparison arm (standard care, minimal intervention or waitlist control condition). The effect on gestational diabetes could not be evaluated due to the scarcity of available studies. Exploration using meta-regressions could not identify any explanatory variable, except for fasting glucose for which the quality score of the articles seems to be an effect modifier decreasing slightly the heterogeneity (72%) in the low risk of bias pooled estimate. High levels of heterogeneity ( I²≥ 81%) were found in most meta-analyses. No publication bias was suggested for these outcomes. Lifestyle interventions decreased the incidence risk ratio of type 2 diabetes by 25% (0♷5 ), and reduced the levels of HbA1c by 0♱5%, fasting plasma glucose by 3♴4 mg/dL, and 2-hr glucose tolerance by 4♱8 mg/dL. A median of 246 (IQR 137-511) individuals participated in the interventions with a median duration of 6 (3-12) months. 54% of the studies were assessed as moderate risk of bias and 14% as high risk. The Lancet Regional Health – Western Pacificįrom 14 330 abstracts, 48 (0♳%) studies with 50 interventions were eligible of which 56% were conducted in lower-middle-income countries, 44% in upper-middle, and none in low-income.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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