Research report: Home-based non-pharmacological interventions for cognition and diabetes self-management in adults with type 2 diabetes: a systematic review

A systematic review of 10 randomised controlled trials found that home-based non-pharmacological interventions may improve selected cognitive or physical outcomes in adults with type 2 diabetes, but the current evidence cannot establish that these changes translate into better diabetes self-management or glycaemic control. Exercise produced the most consistent physical-performance benefits, while cognitive training improved the abilities targeted by the programmes or closely related “near-transfer” tasks. Evidence for multidomain and sensory-based interventions remained preliminary.

The review, published in BMC Public Health , examined interventions delivered at home without pharmaceutical treatment. It followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO. The researchers searched seven electronic databases from their inception through 11 March 2026 for randomised controlled trials and quasi-experimental studies involving adults with type 2 diabetes.

Study quality was evaluated with the Cochrane Risk of Bias 2 tool, while certainty of evidence was assessed through the GRADE approach. Because the interventions and outcomes varied considerably, the findings were synthesized narratively rather than combined in a statistical meta-analysis. Across the 10 included randomised controlled trials, researchers identified four broad categories of home-based intervention: exercise, cognitive training, multidomain programmes and sensory-based approaches.

Exercise-based interventions showed the clearest and most consistent benefits for physical performance. The same interventions had limited and inconsistent effects on cognition, diabetes self-management behaviours and glycaemic indicators. This pattern means that an intervention can produce a measurable benefit in one domain without establishing corresponding improvements in the other domains that matter for diabetes care.

Cognitive training produced improvements in trained or near-transfer cognitive domains, indicating that the targeted cognitive abilities changed in the settings measured by the included studies. The evidence was insufficient, however, to determine whether those gains affected medication adherence, dietary regulation, physical activity, glucose monitoring, HbA1c or other clinical outcomes. A central limitation was that few studies assessed both cognition and diabetes self-management, and none directly tested the proposed pathway in which an intervention changes cognition and that cognitive change subsequently improves diabetes-related functional outcomes.

As a result, the review could not establish that cognitive gains mediate better self-management or glycaemic outcomes. Evidence for multidomain and sensory-based interventions was also preliminary, with too little consistent information to draw firm conclusions about their effects. The review also found that few studies recruited participants who were cognitively vulnerable, limiting the applicability of the findings to groups in which cognitive difficulties might be especially relevant.

The authors concluded that current home-based non-pharmacological interventions may improve selected cognitive or physical outcomes, but evidence remains insufficient to show that these benefits translate into diabetes self-management or glycaemic improvement. They call for future public-health and chronic-disease self-management interventions to be scalable, behaviourally integrated and designed to connect cognitive processes with real-world self-management behaviours and clinical outcomes.

Subject of Research: Evidence on home-based non-pharmacological interventions for cognition and diabetes self-management in adults with type 2 diabetes

Article Title: Home-based non-pharmacological interventions for cognition and diabetes self-management in adults with type 2 diabetes: a systematic review

Article References: Lu, X., Chen, S.-C., Yeung, W. F., Ho, J. Y. S., & Wong, A. K. C. (2026). Home-based non-pharmacological interventions for cognition and diabetes self-management in adults with type 2 diabetes: a systematic review. BMC Public Health. https://doi.org/10.1186/s12889-026-29854-0

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29854-0

Keywords: type 2 diabetes, home-based interventions, systematic review, cognitive training, exercise, diabetes self-management, glycaemic control, randomised controlled trials, GRADE, non-pharmacological care, Home-based, non-pharmacological