SMART goals are recommended in other NHS-backed programmes (i.e. NDPP). While coaching and behaviour change is seen an important component of improving T2DM outcomes often evidence for the use of tools is lacking compared to other factors that contribute to or improve diabetes outcomes.

An intervention with the main focus on SMART goals (n=33) alongside educational information provided by the ADA led to some modest improvement in Hba1c (61.6 to 60.5 mmol/mol – 0.8 points drop). Feedback from participants reported it to be a useful tool, finding it easy to use, and that they would continue to use it (Snyder, 2022).

The main drawback is that there was not a control group, and the only intervention was not SMART, as it involved using SMART within the context of a lifestyle intervention. A second study compared a control group with the SMART intervention group, with the only difference not using SMART as a tool.

Over 3 months the SMART goal intervention group (n=50) dropped Hba1c by 1.2% DCCT (13mmol/mol) compared to the control group (n=50) who dropped by 0.85% DCCT (9.3 mmol/mol). In the short-term this programme suggests improved outcomes with SMART goal setting (Cook, Garris, Gulum, & Steber, 2022).