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The Effect of Weight Reduction Interventions for Persons With Type 2 Diabetes

A Meta-analysis From a Self-regulation Perspective

From Leiden University (Dr Huisman, Dr De Gucht, Dr Maes), and TNO Leiden (Dr Dusseldorp), Leiden, The Netherlands.

Correspondence to Sasja D. Huisman, MSc, PhD, Leiden University, Section of Clinical and Health Psychology, Wassenaarseweg 52, PO Box 9555, 2300 RB Leiden, The Netherlands (shuisman{at}fsw.leidenuniv.nl).

Purpose

The main purpose of this article was to investigate the value of a self-regulation approach for weight reduction interventions in patients with type 2 diabetes. In addition, the potentially moderating effect of other intervention characteristics was explored.

Methods

In a meta-analysis of 34 studies, overall effect sizes were calculated for weight and A1C. The focus of the analysis was, however, on the moderating effect of intervention characteristics, especially whether interventions that score high on self-regulation produce stronger effects.

Results

The overall effect sizes (d) for weight loss in the short term (<6 months) were low and even lower in the longer term (>6 months). The overall effect sizes for A1C outcomes were higher and remained stable in the longer term. Interventions that scored high on self-regulation characteristics produced significantly better effects on both weight and A1C outcomes. Furthermore, "goal reformulation" increased the effect on weight outcomes whereas "emotion regulation" increased the effect on A1C. With respect to the other intervention characteristics, only the "inclusion of a patient's partner or relative" increased the effect on weight loss.

Conclusions

This meta-analysis underlines the importance of a self-regulation approach for weight reduction interventions in diabetes patients, in particular, for A1C outcomes. However, more research is needed to fully understand the relationship among self-regulation, weight, and A1C.

This version was published on September 1, 2009

The Diabetes Educator, Vol. 35, No. 5, 818-835 (2009)
DOI: 10.1177/0145721709340929


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