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Behavioral interventions to improve self-management in Iranian adults with type 2 diabetes: a systematic review and meta-analysis

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The aim of this study was to systematically-review published experimental studies to determine the effectiveness of behavioral interventions on self-management in Iranian adults with type 2 diabetes.


Pub Med, Web of Science, Science Direct, Ovid Medline, EBSCO, ProQuest, Google Scholar, and the Scientific Information Database (SID) were searched for English and Persian language studies published between 2009 and 2017. The primary outcome of this review was to assess the effects of behavioral interventions on glycosylated hemoglobin. Changes in the blood pressure, Lipid profiles, BMI, Self-efficacy, knowledge, attitude, practice, Self-care behaviors, social support, anxiety, and depression were the secondary outcomes.


Comprehensive search procedures resulted in twenty-three experimental studies with 2208 participants. Eleven studies were included in the Meta-analysis. Compared with the control group, behavioral interventions significantly lower glycosylated hemoglobin −0.61% (95% CI -0.80, −0.41). To explore the effects of the study intervention (regarding what aspects of the intervention are most effective), we then conducted a stratified analysis for HbA1c. Larger effects were found in interventions with a longer duration and higher intensity, delivered in the group format, interventions offered to individuals with higher baseline HbA1c, and interventions delivered by a multidisciplinary team. Moreover, behavioral interventions were effective in improving blood glucose, lipid profiles, knowledge, attitude, practice, self-efficacy, quality of life, and self-care.


In line with other behavioral studies, our study shows that behavioral interventions improve self-management in Iranian adults with type 2 diabetes.

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University Putra Malaysia (UPM) supported this study in cooperation with Ilam University of Medical Science, Ilam, IR Iran.


This research received financial support from Ilam University of Medical Science, Ilam, IR Iran.

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Authors and Affiliations



Study concept and design: GA, SKL, SG, And SS. Acquisition of data: GA, SA. Analysis and interpretation of data: GA, SKL, SG, SS, and SA. Drafting of the manuscript: GA and SA. Critical revision of the manuscript for important intellectual content: SKL, SG, SS, and SA. Statistical analysis: GA and SA. Study Supervision: SKL, SG, SS, and SA. All authors have read and approved the final manuscript.

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Correspondence to Golnaz Azami.

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Azami, G., Soh, K.L., Sazlina, SG. et al. Behavioral interventions to improve self-management in Iranian adults with type 2 diabetes: a systematic review and meta-analysis. J Diabetes Metab Disord 17, 365–380 (2018).

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