Aims
Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review ...aimed to determine the effectiveness of group‐based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Methods
Six electronic databases were searched. Group‐based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self‐efficacy.
Results
Fifty‐three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group‐based education compared with controls at 6–10 months n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002, 12–14 months n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001, 18 months n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009 and 36–48 months n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002, but not at 24 months. Outcomes also favoured group‐based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer‐led interventions.
Conclusions
Group‐based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
What's new?
We present a comprehensive up‐to‐date review of the evidence for the effectiveness of Type 2 diabetes group‐based interventions. This is the first review in the area to complete a meta‐regression.
We report statistically significant results for improving HbA1c, fasting blood glucose, body weight, waist circumference, triglycerides and diabetes knowledge, but clinical improvement is more nuanced.
Group‐based interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters appear to be more effective at improving HbA1c than peer‐led interventions.
Aims
To assess the completeness of reporting of group‐based education interventions for the management of type 2 diabetes.
Methods
A previous systematic review of group‐based education programmes for ...adults with type 2 diabetes identified eligible intervention studies. Data were extracted and assessed using the Template for Intervention Description and Replication (‘TIDieR’) checklist. Missing data were sourced from other published material, or by contacting authors.
Results
Fifty‐three publications describing 47 studies were included. No publications sufficiently described all items. Authors of 43 of the 47 included studies (91%) were contacted via e‐mail to obtain missing data in order to complete the TIDieR checklist. Seven (16%) did not respond. Additional data were obtained for 33/47 studies (70%). Most studies (45/47, 96%) described the intervention duration and frequency, detailed the procedures and rationale (40/47, 85%), provided a brief intervention name and explained any individual tailoring (38/47, 81%), defined whether providers received training and adequately described how the programme was delivered (37/47, 79%). However, few described any modifications (28/47, 60%), whether the intervention was delivered as planned (27/47, 57%), where it was delivered (21/47, 45%), whether materials were provided (19/47, 40%), and who delivered the intervention (13/47, 28%).
Conclusions
Group‐based education interventions for the management of type 2 diabetes are poorly reported. To translate effective research into practice, practitioners need sufficient detail to implement evidence‐based interventions. Researcher adoption of the TIDieR checklist will assist the translation and replication of published interventions.
What's new?
Group‐based education for the management of type 2 diabetes is effective in improving HbA1c, fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge.
Poorly reported interventions impede intervention replication and research translation.
Group‐based education interventions for the management of type 2 diabetes are poorly reported and often incomplete.
Authors should use the Template for Intervention Description and Replication (‘TIDieR’) checklist to plan and report interventions completely to assist the replication and implementation of interventions, and improve group‐based education and outcomes for people with type 2 diabetes in practice.
We report results from searches for new physics with low-energy electronic recoil data recorded with the XENON1T detector. With an exposure of 0.65 tonne-years and an unprecedentedly low background ...rate of 76 ± 2stat events/(tonne × year × keVÞ between 1 and 30 keV, the data enable one of the most sensitive searches for solar axions, an enhanced neutrino magnetic moment using solar neutrinos, and bosonic dark matter. An excess over known backgrounds is observed at low energies and most prominent between 2 and 3 keV. The solar axion model has a 3.4σ significance, and a three-dimensional 90% confidence surface is reported for axion couplings to electrons, photons, and nucleons. This surface is inscribed in the cuboid defined by gae < 3.8 × 10−12, ..., and gaegaγ < 7.7 × 10−22 GeV−1, and excludes either gae = 0 or ... . The neutrino magnetic moment signal is similarly favored over background at 3.2σ, and a confidence interval of μν ∈ (1.4, 2.9) × 10−11 μB (90% C.L.) is reported. Both results are in strong tension with stellar constraints. The excess can also be explained by β decays of tritium at 3.2σ significance with a corresponding tritium concentration in xenon of (6.2 ± 2.0) × 10−25 mol/mol. Such a trace amount can neither be confirmed nor excluded with current knowledge of its production and reduction mechanisms. The significances of the solar axion and neutrino magnetic moment hypotheses are decreased to 2.0σ and 0.9σ, respectively, if an unconstrained tritium component is included in the fitting. With respect to bosonic dark matter, the excess favors a monoenergetic peak at (2.3 ± 0.2) keV (68% C.L.) with a 3.0σ global (4.0σ local) significance over background. This analysis sets the most restrictive direct constraints to date on pseudoscalar and vector bosonic dark matter for most masses between 1 and 210 keV/c2. We also consider the possibility that 37Ar may be present in the detector, yielding a 2.82 keV peak from electron capture. Contrary to tritium, the 37Ar concentration can be tightly constrained and is found to be negligible. (ProQuest: ... denotes formula omitted.)
We report constraints on light dark matter (DM) models using ionization signals in the XENON1T experiment. We mitigate backgrounds with strong event selections, rather than requiring a scintillation ...signal, leaving an effective exposure of (22±3) tonne day. Above ∼0.4 keV_{ee}, we observe <1 event/(tonne day keV_{ee}), which is more than 1000 times lower than in similar searches with other detectors. Despite observing a higher rate at lower energies, no DM or CEvNS detection may be claimed because we cannot model all of our backgrounds. We thus exclude new regions in the parameter spaces for DM-nucleus scattering for DM masses m_{χ} within 3-6 GeV/c^{2}, DM-electron scattering for m_{χ}>30 MeV/c^{2}, and absorption of dark photons and axionlike particles for m_{χ} within 0.186-1 keV/c^{2}.
We report the first experimental results on spin-dependent elastic weakly interacting massive particle (WIMP) nucleon scattering from the XENON1T dark matter search experiment. The analysis uses the ...full ton year exposure of XENON1T to constrain the spin-dependent proton-only and neutron-only cases. No significant signal excess is observed, and a profile likelihood ratio analysis is used to set exclusion limits on the WIMP-nucleon interactions. This includes the most stringent constraint to date on the WIMP-neutron cross section, with a minimum of 6.3×10^{-42} cm^{2} at 30 GeV/c^{2} and 90% confidence level. The results are compared with those from collider searches and used to exclude new parameter space in an isoscalar theory with an axial-vector mediator.
We present that the next-generation Enriched Xenon Observatory (nEXO) is a proposed experiment to search for neutrinoless double- β (0νββ) decay in 136Xe with a target half-life sensitivity of ...approximately 1028 yr using 5 × 103 kg of isotopically enriched liquid-xenon in a time projection chamber. This improvement of two orders of magnitude in sensitivity over current limits is obtained by a significant increase of the 136Xe mass, the monolithic and homogeneous configuration of the active medium, and the multiparameter measurements of the interactions enabled by the time projection chamber. Finally, the detector concept and anticipated performance are presented based upon demonstrated realizable background rates.
We report on a search for nuclear recoil signals from solar B-8 neutrinos elastically scattering off xenon nuclei in XENON1T data, lowering the energy threshold from 2.6 to 1.6 keV. We develop a ...variety of novel techniques to limit the resulting increase in backgrounds near the threshold. No significant B-8 neutrinolike excess is found in an exposure of 0.6 t x y. For the first time, we use the nondetection of solar neutrinos to constrain the light yield from 1-2 keV nuclear recoils in liquid xenon, as well as nonstandard neutrino-quark interactions. Finally, we improve upon world-leading constraints on dark matter-nucleus interactions for dark matter masses between 3 and 11 GeV c(-2) by as much as an order of magnitude.
The XENON1T experiment searches for dark matter particles through their scattering off xenon atoms in a 2 metric ton liquid xenon target. The detector is a dual-phase time projection chamber, which ...measures simultaneously the scintillation and ionization signals produced by interactions in target volume, to reconstruct energy and position, as well as the type of the interaction. The background rate in the central volume of XENON1T detector is the lowest achieved so far with a liquid xenon-based direct detection experiment. In this work we describe the response model of the detector, the background and signal models, and the statistical inference procedures used in the dark matter searches with a 1 metric ton×year exposure of XENON1T data, that leads to the best limit to date on WIMP-nucleon spin-independent elastic scatter cross section for WIMP masses above 6 GeV/c2.
The XENON1T experiment at the Laboratori Nazionali del Gran Sasso is the most sensitive direct detection experiment for dark matter in the form of weakly interacting particles (WIMPs) with masses ...above 6 GeV/c2 scattering off nuclei. The detector employs a dual-phase time projection chamber with 2.0 metric tons of liquid xenon in the target. A one metric ton×year exposure of science data was collected between October 2016 and February 2018. This article reports on the performance of the detector during this period and describes details of the data analysis that led to the most stringent exclusion limits on various WIMP-nucleon interaction models to date. In particular, signal reconstruction, event selection, and calibration of the detector response to nuclear and electronic recoils in XENON1T are discussed.
PDF
