Nonpharmacological interventions to prevent type 2 diabetes in women diagnosed with gestational diabetes mellitus: a systematic overview Sources of evidence for systematic reviews of interventions in diabetes. The Influence of Yoga-Based Programs on Risk Profiles in Adults with Type 2 Diabetes Mellitus: A Systematic Review The Effectiveness of Exercise on Recovery and Clinical Outcomes in Patients With Soft Tissue Injuries of the Hip, Thigh, or Knee: A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Dietetic guidelines: diet in secondary prevention of cardiovascular disease. Supervised exercise therapy for intermittent claudication in a community-based setting is as effective as clinic-based. Systematic review protocol: single-dose histidine-tryptophan-ketoglutarate vs. intermittent crystalloid or blood cardioplegia. Reporting of Positive Results in Randomized Controlled Trials of Mindfulness-Based Mental Health Interventions Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications
This systematic overview summarizes the relevant evidence from multiple systematic review s of the benefits of nonpharmacological interventions for preventing  type 2 diabetes mellitus ( T2MD ) in women diagnosed with gestational diabetes mellitus ( GDM ) . A comprehensive search using the Cochrane Library , CINAHL , EMBASE and MEDLINE via Ovid SP , and PubMed data bases was completed on 18 November 2015 . Any systematic review s that evaluated r and omized controlled trials ( RCTs ) with defined nonpharmacological interventions for preventing T2DM in women diagnosed with GDM were eligible for inclusion . The authors independently performed critical appraisal s and quality assessment s of the included review s using the AMSTAR tool , and extracted data were converted to coherent values for tabular summarization . Six eligible review s of diet and /or exercise , breastfeeding , and reminder interventions were identified ; however , the method ologies of the review s varied greatly , and the majority of the evidence suggested unclear bias . We found inconsistent reporting on the rates at which diet and exercise interventions reduced the risk of T2DM progression , but these interventions were found to be effective at reducing glycemic load . Combined diet , exercise , and breastfeeding interventions proved to be effective at returning women to their postpartum weight . Neither diet alone nor exercise alone proved to be effective at lowering the risk of T2DM . Overall , there was no robust evidence to support the hypothesis that nonpharmacological interventions are effective at lowering the risk of T2DM in women diagnosed with GDM , and there was no consistent evidence showing that these interventions improved the predictor outcomes of T2DM , such as glycemic load or anthropometric changes AIMS To analyse the effect on systematic review s in diabetes interventions of including only trials that are indexed in medline , and to assess the impact of adding trials from other data bases and the grey literature . METHODS All systematic review s of diabetes interventions which included a meta- analysis of r and omized controlled trials , and were published since 1996 , were selected . The impact on the meta- analysis of including only those trials indexed in medline , and the effect of then adding trials from other sources , was assessed . Where possible this was measured quantitatively , by redoing the meta- analysis , otherwise a qualitative estimate was made . RESULTS Forty-four systematic review s met our inclusion criteria . There were 120 articles reporting trial data which were not indexed in medline . These came from 52 % of the review s. In 34 % of the review s , basing a meta- analysis on a search of only medline would miss trials that could affect the result . Sources of non- medline data which had the biggest effect on the meta-analyses were journal articles from central and embase ( mainly in Diabetes , Nutrition and Metabolism ) and unpublished data ( mainly from industry ) . The exceptions were journal articles on herbal medicine , mostly indexed in Chinese language data bases . CONCLUSIONS A search of only the medline data base is insufficient for systematic review s of diabetes , because in about 34 % of review s the missed trials could affect the results of the meta- analysis . It is recommended that central ( on the Cochrane Library ) also be search ed . Scanning meeting abstract s , and seeking unpublished data are also recommended if the intervention has only recently been introduced There is growing evidence that yoga may offer a safe and cost-effective intervention for Type 2 Diabetes mellitus ( DM 2 ) . However , systematic review s are lacking . This article critically review s the published literature regarding the effects of yoga-based programs on physiologic and anthropometric risk profiles and related clinical outcomes in adults with DM 2 . We performed a comprehensive literature search using four computerized English and Indian scientific data bases . The search was restricted to original studies ( 1970–2006 ) that evaluated the metabolic and clinical effects of  yoga in adults with DM 2 . Studies targeting clinical population s with cardiovascular disorders that included adults with comorbid DM were also evaluated . Data were extracted regarding study design , setting , target population , intervention , comparison group or condition , outcome assessment , data analysis and presentation , follow-up , and key results , and the quality of each study was evaluated according to specific predetermined criteria . We identified 25 eligible studies , including 15 uncontrolled trials , 6 non-r and omized controlled trials and 4 r and omized controlled trials ( RCTs ) . Overall , these studies suggest beneficial changes in several risk indices , including glucose tolerance and insulin sensitivity , lipid profiles , anthropometric characteristics , blood pressure , oxidative stress , coagulation profiles , sympathetic activation and pulmonary function , as well as improvement in specific clinical outcomes .  Yoga may improve risk profiles in adults with DM 2 , and may have promise for the prevention and management of cardiovascular complications in this population . However , the limitations characterizing most studies preclude drawing firm conclusions . Additional high- quality RCTs are needed to confirm and further eluci date the effects of st and ardized yoga programs in population s with DM 2 OBJECTIVE The purpose of this systematic review was to determine the effectiveness of exercise for the management of soft tissue injuries of the hip , thigh , and knee . METHODS We conducted a systematic review and search ed MEDLINE , EMBASE , PsycINFO , the Cochrane Central Register of Controlled Trials , and CINAHL Plus with Full Text from January 1 , 1990 , to April 8 , 2015 , for r and omized controlled trials ( RCTs ) , cohort studies , and case-control studies evaluating the effect of exercise on pain intensity , self-rated recovery , functional recovery , health-related quality of life , psychological outcomes , and adverse events . R and om pairs of independent review ers screened titles and abstract s and assessed risk of bias using the Scottish Intercollegiate Guidelines Network criteria . Best evidence synthesis methodology was used . RESULTS We screened 9494 citations . Eight RCTs were critically appraised , and 3 had low risk of bias and were included in our synthesis . One RCT found statistically significant improvements in pain and function favoring clinic-based progressive combined exercises over a " wait and see " approach for patellofemoral pain syndrome . A second RCT suggests that supervised closed kinetic chain exercises may lead to greater symptom improvement than open chain exercises for patellofemoral pain syndrome . One RCT suggests that clinic-based group exercises may be more effective than multimodal physiotherapy in male athletes with persistent groin pain . CONCLUSION We found limited high- quality evidence to support the use of exercise for the management of soft tissue injuries of the lower extremity . The evidence suggests that clinic-based exercise programs may benefit patients with patellofemoral pain syndrome and persistent groin pain . Further high- quality research is needed AIM To produce dietetic guidelines summarizing the systematic review evidence on dietary advice for secondary prevention of cardiovascular disease . METHODS The Cochrane Library , MEDLINE and EMBASE were comprehensively search ed for systematic review s on aspects of diet and heart health . Review s were included if they search ed systematic ally for r and omised controlled trials relating to diet and secondary prevention of cardiovascular disease . Two members of the UK Heart Health and Thoracic Dietitians Group critically appraised each review . The quality and results of each review were discussed and summarized in a whole group meeting . The guidelines were trialled in seven dietetic departments and modified where necessary . RESULTS Providing evidence -based dietary information ( including increasing omega-3 fat plus fruit and vegetable intake ) to all people after myocardial infa rct ion will save more lives than concentrating dietary advice on those in need of weight loss or lipid lowering . The practice of prioritizing dietetic time to those with raised lipids is out of date since the advent of statin therapy . CONCLUSION There is good systematic review evidence that dietary advice to those with cardiovascular disease can reduce mortality and morbidity as well as modify risk factors .  Dietary advice that does this most effectively should be prioritized OBJECTIVE This cohort study was conducted to determine the effect on walking distances of supervised exercise therapy provided in a community-based setting . METHODS The study included all consecutive patients presenting at the vascular outpatient clinic with intermittent claudication , diagnosed by a resting ankle brachial index<0.9 , who had no previous peripheral vascular intervention for peripheral arterial disease , no major amputation , and sufficient comm and of the Dutch language . The exclusion criterion was the inability to walk the baseline treadmill test for a minimum of 10 m. The intervention was a supervised exercise therapy in a community-based setting . A progressive treadmill test at baseline and at 1 , 3 , and 6 months of follow-up measured initial claudication distance and absolute claudication distance . Changes were calculated using the mean percentages of change . RESULTS From January through October 2005 , 93 consecutive patients with claudication were eligible . Overall , 37 patients discontinued the supervised exercise therapy program . Eleven stopped because of intercurrent diseases , whereas for 10 , supervised exercise therapy did not lead to adequate improvement and they underwent a vascular intervention . Three patients quit the program , stating that they were satisfied with the regained walking distance and did not require further supervised exercise therapy . Ten patients were not motivated sufficiently to continue the program , and in three patients , a lack of adequate insurance coverage was the reason for dropping out . Data for 56 patients were used and showed a mean percentage increase in initial claudication distance of 187 % after 3 months and 240 % after 6 months . The mean percentage of the absolute claudication distance increased 142 % after 3 months and 191 % after 6 months . CONCLUSION Supervised exercise therapy in a community-based setting is a promising approach to providing conservative treatment for patients with intermittent claudication Studies that compare the use of HTK vs. blood or crystalloid cardioplegia for myocardial protection in cardiac surgery , r and omized or non-r and omized , will be selected . Large case series of adult cardiac surgery with the use of HTK for myocardial protection but without a comparator , including more than 100 patients will be included in a separate analysis . Electronic search es will be performed of Medline , the Cochrane Data base of Systematic Review s , Pubmed and EMBASE . Manual search es of reference lists will be used to identify any studies not found in the initial search . Only studies in English will be included . Abstract s , letters , and review articles will be excluded . Differences of opinion between review ers will be discussed with a senior investigator . An in/out form will be prepared to assess studies for inclusion or exclusion using predetermined inclusion criteria . The inclusion of studies will be assessed by two independent review ers , with differences of opinion resolved by discussion with a senior investigator . A PRISMA flow-diagram will summarize inclusion /exclusion of studies . Level of evidence for each study will be reported to assess the quality of the evidence Background A large proportion of mindfulness-based therapy  trials report statistically significant results , even in the context of very low statistical power . The objective of the present study was to characterize the reporting of “ positive ” results in r and omized controlled trials of mindfulness-based therapy . We also assessed mindfulness-based therapy trial registration s for indications of possible reporting bias and review ed recent systematic review s and meta-analyses to determine whether reporting biases were identified . Methods CINAHL , Cochrane CENTRAL , EMBASE , ISI , MEDLINE , PsycInfo , and SCOPUS data bases were search ed for r and omized controlled trials of mindfulness-based therapy . The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression . Trial registries were search ed for mindfulness-based therapy registration s. CINAHL , Cochrane CENTRAL , EMBASE , ISI , MEDLINE , PsycInfo , and SCOPUS were also search ed for mindfulness-based therapy systematic review s and meta-analyses . Results 108 ( 87 % ) of 124 published trials reported ≥1 positive outcome in the abstract , and 109 ( 88 % ) concluded that mindfulness-based therapy was effective , 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 ( expected number positive trials = 65.7 ) . Of 21 trial registration s , 13 ( 62 % ) remained unpublished 30 months post-trial completion . No trial registration s adequately specified a single primary outcome measure with time of assessment . None of 36 systematic review s and meta-analyses concluded that effect estimates were overestimated due to reporting biases . Conclusions The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice Introduction Insulin analog glargine ( GLA ) has been available as one of the therapeutic options for patients with type 1 diabetes mellitus to enhance glycemic control . Studies have shown that a decrease in the frequency of hypoglycemic episodes improves the quality of life ( QoL ) of diabetic patients . However , there are appreciable acquisition cost differences between different insulins . Consequently , there is a need to assess their impact on QoL to provide future guidance to health authorities . Method A systematic review of multiple data bases including Medline , LILACS , Cochrane , and EMBASE data bases with several combinations of agreed terms involving r and omized controlled trials and cohorts , as well as manual search es and gray literature , was undertaken . The primary outcome measure was a change in QoL. The quality of the studies and the risk of bias was also assessed . Results Eight studies were eventually included in the systematic review out of 634 publications . Eight different QoL instruments were used ( two generic , two mixed , and four specific ) , in which the Diabetes Treatment Satisfaction Question naire ( DTSQ ) was the most used . The systematic review did not consistently show any significant difference overall in QoL scores , whether as part of subsets or combined into a single score , with the use of GLA versus neutral protamine Hagedorn ( NPH ) insulin . Only in patient satisfaction measured by DTSQ was a better result consistently seen with GLA versus NPH insulin , but not using the Well-being Inquiry for Diabetics ( WED ) scale . However , none of the cohort studies scored a maximum on the Newcastle – Ottawa scale for quality , and they generally were of moderate quality with bias in the studies . Conclusion There was no consistent difference in QoL or patient-reported outcomes when the findings from the eight studies were collated . In view of this , we believe the current price differential between GLA and NPH insulin in Brazil can not be justified by these findings
On the contrary , the largest study of this review did not demonstrate any adverse effect of  DM on MWD and FWD after SET .
In conclusion , the data evaluating the effects of DM on SET were inadequate to determine if DM impairs the exercise response .
Some believe that certain patients with intermittent claudication may be unsuitable for supervised exercise therapy ( SET ) , based on the presence of comorbidities and the possibly increased risks .
We conducted a systematic review ( MEDLINE , EMBASE and CENTRAL ) to summarize evidence on the potential influence of diabetes mellitus ( DM ) on the response to SET .