Lifestyle interventions for improving health and health behaviours in women with type 2 diabetes: A systematic review of the literature 2011–2017

Abstract

The development and maintenance of healthy lifestyle behaviours are among the most promising strategies for reducing complications and premature death among women living with type 2 diabetes mellitus (T2DM). However, despite the potential benefits of these interventions, they have had varying success and the sustained uptake of the recommended lifestyle modifications is limited. This paper reviews research on the impact of lifestyle interventions aimed at improving health and health behaviours in women with T2DM. In a systematic review of the literature, empirical literature from 2011 to 2017 is examined to explore the effects of various lifestyle interventions on a number of objective and subjective health indicators in women with T2DM. A total of 18 intervention studies in women aged between 21 and 75 years were included in this narrative review. Interventions included education/counselling, exercise, diet, or combined components of varying duration. The included studies used a variety of objective indicators, including glycaemic control, lipid profile and anthropometric indices, as well as a number of diabetes-specific and generic subjective scales (for example, the Diabetes Problem Solving Inventory and the Short Form 36). Significant heterogeneity was noted in the interventions and also the study findings, although exercise interventions tended to yield the most consistent benefit in relation to glycaemic control, while exercise/dietary interventions generally improved anthropometric indices. The findings from this review did not consistently suggest the greater value of any one type of intervention. Future research should consider interventions that target multiple health behaviours and emphasize health literacy, self-efficacy, and problem-solving skills.

A healthy lifestyle education programme for health literacy and health‐promoting behaviours: A pre‐implementation and post‐implementation study

“…Moreover, although the education level and the family income of the women were relatively high, approximately one in every two women was obese in this study. This finding supports the literature that indicates a relationship between health perceptions and nutritional habits (Seib et al, ; Taggart et al, ).…”

“…Unlike many studies performed with disease‐specific samples, this was a community‐based study, and it was conducted with community‐dwelling women without any co‐morbidity using both national and global measurement tools (Neupane et al, ; Sand‐Jecklin et al, ; Seib et al, ; Taggart et al, ). Another strength of the intervention was that the education content targeted increasing health literacy and its applicability in the community health care services.…”

“…Health literacy is the ability to meet knowledge-based literacy needs (obtaining, understanding, and using health knowledge) based on literacy skills (reading and writing), which is necessary to take decisions about health (Nutbeam, 2017). Health literacy implies the ability to use the Internet, to read brochures about health, to calculate medicine doses, to understand, and to comply with verbal and written health care instructions (James, Harville, Efunbumi, & Martin, 2015;Messadi, Macek, Markovic, & Atchison, 2018;Seib et al, 2018;Tsai, Lee, & Yu, 2018).…”

Using the Pharmaceutical Collection Database to identify patient adherence to oral hypoglycaemic medicines

“…3,4 Oral hypoglycaemic medications are the mainstay therapy for type 2 diabetes in conjunction with diet and exercise modifications. [5][6][7] However, adherence to these medications continues to be sub-optimal, so health services are concerned with finding ways to improving patient adherence. [8][9][10] Abnormally high levels of HbA1c (haemoglobin A1c) are a marker for hyperglycaemia.…”

Effectiveness of educational intervention based on psychological factors on achieving health outcomes in patients with type 2 diabetes

“…In this respect, adherence to a healthy diet has been recognized as the first step [10, 11] and the most complicated dimension of diabetes management [12] which can consequently lead to stable improvement in the levels of glycated hemoglobin (HbA1c) [13] and control of blood sugar in patients [14, 15]. In spite of much progress within diabetes management, non-adherence to prescribed treatments including dietary recommendations, is taken into account as a major barrier to the control of blood sugar levels in various countries [16–18] which can even expose patients to risks of seriously chronic complications and early death [18–20]. According to the related literature, low adherence to prescribed diets has been constantly reported in patients with T2D [12, 21, 22].…”