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1Traditional Medicine Research  2019, Vol. 4 Issue (6): 314-325    DOI: 10.12032/TMR20191024143
Special Issue on Endocrine and Metabolism     
Effectiveness of health coaching on diabetic patients: A systematic review and meta-analysis
Nashwa Mohamed Radwan1,2,*(), Hisham Al Khashan3, Fahad Alamri3, Ahmed Tofek El Olemy4
1Department of Public Health and Community Medicine, Tanta University, Tanta, Egypt
2Consultant in Clinical Education Department, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
3Family Medicine Consultant, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
4National Center for Complementary and Alternative Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
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Health coaching intervention has a significant effect on hemoglobin A1c and high-density lipoprotein cholesterol of patients with diabetes mellitus.


The first use of the term "coach" arose around 1830 in Oxford University as a slang in relation with an instructor or trainer or tutor who "carried" a student through an exam. The term “coaching” thus refers to the process of transporting people from where they are to where they want to be. In 1915, the National Board of Medical Examiners was founded. In 2002, Wellcoaches partnered with the American College of Sports Medicine. In 2010, the National Consortium for Credentialing Health and Wellness Coaches was founded. In 2017, the International Consortium for Health and Wellness Coaching was established. Coaching as a method to improve healthy lifestyle behaviors has received special attention in recent years.


Background: Using health coaching to improve the quality of life and health outcomes of the patients with diabetes mellitus, has emerged as a possible intervention. However, the few published randomized controlled trials using health coaching for patients with diabetes mellitus have reported mixed results. The present meta-analysis aimed to determine the effectiveness of health coaching on modifying health status and quality of life among diabetic patients and to clarify the characteristics of coaching delivery that make it most effective. Methods: This study searched for articles on randomized controlled trials of health coaching interventions targeting type 2 diabetic patients that were published in the English language from January 2005 through December 2018 in the Cochrane, Medline, PubMed, Trip, and Embase databases. Patients in the control group received usual diabetes mellitus care, and those in the experimental group received health coaching based on usual diabetes mellitus care. The primary outcomes included Hemoglobin A1c (HbA1c) and cardiovascular disease risk factors, including systolic blood pressure, diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, and body weight. The secondary outcomes included quality of life, self-efficacy, self-care skills, and psychological outcomes. Results: Health coaching intervention has a significant effect on HbA1c [mean difference (MD) = -0.35, confidence interval (CI) = -0.47, -0.22, I2 = 83%, P < 0.001] and HDL-C (MD = -0.50, CI = -0.93, -0.07, I2 = 10%, P = 0.02). The most effective strategy for health coaching delivery associated with improvement of HbA1c was decreasing the number of sessions and increasing the duration of each session. However, no significant difference was found for weight, SBP, diastolic blood pressure, triglyceride, low-density lipoprotein cholesterol, or total cholesterol. Mixed results were reported for the effect of health coaching on quality of life, self-efficacy, self-care skills, and depressive symptoms outcome. Conclusion: Health coaching intervention has a significant effect on HbA1c and HDL-C, and the most effective strategy is decreasing the number of sessions while increasing session duration. However, these results should be interpreted with caution as the evidence comes from studies at some risk of bias with considerable heterogeneity and imprecision.

Key wordsHealth coaching      Type 2 diabetes mellitus      Randomized controlled trials      Hemoglobin A1c      Weight      High-density lipoprotein cholesterol.     
Published: 05 November 2019
Corresponding Authors: Nashwa Mohamed Radwan   
Cite this article:

Nashwa Mohamed Radwan, Hisham Al Khashan, Fahad Alamri, Ahmed Tofek El Olemy. Effectiveness of health coaching on diabetic patients: A systematic review and meta-analysis. 1Traditional Medicine Research, 2019, 4(6): 314-325. doi: 10.12032/TMR20191024143


Outcome MD CI Number of participants Heterogeneity Quality of evidence
HbA1c - 0.35 -0.47, -0.22 3,645 I2 = 83%, P < 0.001 Moderate
SBP - 0.82 -2.83, 1.20 2,949 I2 = 94%, P < 0.001 Moderate
DBP 0.13 -1.52, 1.78 2,556 I2 = 98%, P < 0.001 Moderate
Weight -5.09 -10.12, -0.07 2,099 I2 = 92%, P < 0.001 Low
Total cholesterol -1.88 -9.06, 5.29 2,816 I2 = 96%, P < 0.001 Low
HDL-C -0.50 -0.93, -0.07 1,405 I2 = 10%, P = 0.35 Low
LDL-C -1.97 -9.37, 5.43 1,841 I2 = 96%, P < 0.001 Low
Triglyceride -3.11 -7.54, 1.33 1,665 I2 = 72%, P = 0.01 Low
Table 1 Summary of the main outcomes of the included studies
Figure 1 The paper flow chart
Figure 2 Risk of bias percentages of included studies
Figure 3 Characteristics of the health coaching delivery
Figure 4 Forest plot of the mean difference of HbA1c after health coaching
Figure 5 Funnel plot of the mean difference for HbA1c
Figure 6 Forest plot of high-density lipoprotein cholesterol after coaching intervention
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[1] Yu-Hong Ding, Xing-Yu Zheng, Wei-Wei Chen, Xin-Fu Lin, Xiao Yang, Jie-Wei Luo, Fang-Meng Huang, Yong-Xi Wu, Shi-Chao Wei. Study on the relationship between the structure of bacterial flora on the tongue and types of tongue coating in patients with type 2 diabetes mellitus[J]. 1Traditional Medicine Research, 2019, 4(6): 326-337.