Impact of individual and environmental factors on dietary or lifestyle interventions to prevent type 2 diabetes development: a systematic review

Authors

Dhanasekaran Bodhini, Madras Diabetes Research Foundation
Robert W. Morton, McMaster University, Faculty of Health Sciences
Vanessa Santhakumar, Brigham and Women's Hospital
Mariam Nakabuye, Novo Nordisk Foundation Center for Basic Metabolic Research
Hugo Pomares-Millan, Institutionen för Kliniska Vetenskaper, Malmö
Hugo Pomares-Millan, Institutionen för Kliniska Vetenskaper, Malmö
Christoffer Clemmensen, Novo Nordisk Foundation Center for Basic Metabolic Research
Stephanie L. Fitzpatrick, Northwell Health System
Marta Guasch-Ferre, Novo Nordisk Foundation Center for Basic Metabolic Research
James S. Pankow, School of Public Health
Mathias Ried-Larsen, Rigshospitalet
Paul W. Franks, Novo Nordisk Foundation
Stephen S. Rich, University of Virginia School of Medicine
Robert Wagner, Deutsches Diabetes-Zentrum
Tina Vilsbøll, Steno Diabetes Center Copenhagen
Kimberly K. Vesco, Kaiser Permanente Center for Health Research
Miriam S. Udler, Massachusetts General Hospital
Tiinamaija Tuomi, Helsinki University Hospital
Arianne Sweeting, Faculty of Medicine and Health
Emily K. Sims, Indiana University School of Medicine
Jennifer L. Sherr, Yale School of Medicine
Robert K. Semple, Edinburgh Medical School
Rebecca M. Reynolds, Edinburgh Medical School
Maria J. Redondo, Baylor College of Medicine
Leanne M. Redman, Pennington Biomedical Research Center
Richard E. Pratley, AdventHealth Translational Research Institute
Rodica Pop-Busui, University of Michigan Medical School
Toni I. Pollin, University of Maryland School of Medicine
Wei Perng, University of Colorado Anschutz Medical Campus
Ewan R. Pearson, University of Dundee School of Medicine
Susan E. Ozanne, University of Cambridge
Katharine R. Owen, University of Oxford Medical Sciences Division
Richard Oram, University of Exeter Medical School
Rinki Murphy, Faculty of Medical and Health Sciences

Document Type

Article

Publication Date

12-1-2023

Abstract

Background: The variability in the effectiveness of type 2 diabetes (T2D) preventive interventions highlights the potential to identify the factors that determine treatment responses and those that would benefit the most from a given intervention. We conducted a systematic review to synthesize the evidence to support whether sociodemographic, clinical, behavioral, and molecular factors modify the efficacy of dietary or lifestyle interventions to prevent T2D. Methods: We searched MEDLINE, Embase, and Cochrane databases for studies reporting on the effect of a lifestyle, dietary pattern, or dietary supplement interventions on the incidence of T2D and reporting the results stratified by any effect modifier. We extracted relevant statistical findings and qualitatively synthesized the evidence for each modifier based on the direction of findings reported in available studies. We used the Diabetes Canada Clinical Practice Scale to assess the certainty of the evidence for a given effect modifier. Results: The 81 publications that met our criteria for inclusion are from 33 unique trials. The evidence is low to very low to attribute variability in intervention effectiveness to individual characteristics such as age, sex, BMI, race/ethnicity, socioeconomic status, baseline behavioral factors, or genetic predisposition. Conclusions: We report evidence, albeit low certainty, that those with poorer health status, particularly those with prediabetes at baseline, tend to benefit more from T2D prevention strategies compared to healthier counterparts. Our synthesis highlights the need for purposefully designed clinical trials to inform whether individual factors influence the success of T2D prevention strategies.

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