REVITALIZING DIABETES CARE: A SYSTEMATIC REVIEW OF NUTRITIONAL INTERVENTIONS, ADHERENCE STRATEGIES, AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH IN TYPE 2 DIABETES MANAGEMENT

Main Article Content

Anosha Khan
Shehar Bano
Mauricio Alejandro Alvarado Mira
Tazeem Akhtar
Aqsa Azhar
Iesha Binte Shams
Areeja Nasir
Rabia Taj

Keywords

Diabetes Care, Adherence Strategies, Nutritional Interventions, Type 2 Diabetes Management, Social Determinants of Health

Abstract

Background: There has been significant increase in global prevalence of Type 2 Diabetes (T2D).  It necessitates a holistic approach to care. Therefore, this systematic review explores T2D management's multifaceted nature. Thus, emphasizes on three pivotal dimensions which include nutritional interventions, adherence strategies, and social determinants of health (SDOH). T2D's complexity is shaped by genetics, environment, and lifestyle factors. However, it requires a comprehensive approach beyond traditional pharmaceutical interventions.


 


Methods: Within the last decade a rigorous search strategy following PRISMA guidelines identified 29 relevant studies published. Therefore, studies were selected based on their focus on T2D management, nutritional interventions, adherence strategies, and SDOH. Thus, data were systematically assessed and extracted for quality and relevance.


 


Results: Nutritional interventions include dietary patterns. These are mediterranean diet, low-carbohydrate diets, and plant-based diets are included in it. They have shown promise in improving glycemic control. It also helps in reducing cardiovascular risk factors in T2D patients. Therefore, personalized nutrition tailored to individual genetics and metabolism is emerging approach. Furthermore, patient-centered adherence strategies, such as education and goal setting, empower individuals to actively participate in their care. So, healthcare provider communication and cultural competence play critical roles. Addressing SDOH, such as income disparities and food insecurity, is integral to comprehensive T2D management. To tackle these determinants community-based programs and policy changes are essential.


 


Conclusion: In Managing Type 2 Diabetes, a holistic approach beyond pharmaceutical interventions is required. Therefore, nutritional interventions, adherence strategies, and consideration of SDOH are pivotal components. Certainly, emerging research highlights personalized nutrition, patient-centered care, and interventions targeting food insecurity and health literacy. To enhance the well-being of individuals with T2D, this systematic review contributes to evolving knowledge, identifies gaps, and shapes future interventions.

Abstract 192 | PDF Downloads 59

References

1. Akthar, N., et al. (2023). "Determinants of patient satisfaction in Asia: Evidence from systematic review of literature." Clinical Epidemiology and Global Health: 101393.
2. Ariganjoye, F. I. (2021). "Effects of Social Determinants of Health in Progression to Type 2 Diabetes."
3. Aroda, V. R. and R. H. Eckel (2022). "Reconsidering the role of glycaemic control in cardiovascular disease risk in type 2 diabetes: A 21st century assessment." Diabetes, Obesity and Metabolism 24(12): 2297-2308.
4. Barber, T. M., et al. (2020). "The health benefits of dietary fibre." Nutrients 12(10): 3209.
5. Byrne, F. N., et al. (2021). "Translation of nutrient level recommendations to control serum phosphate into food-based advice." Journal of Renal Nutrition 31(1): 43-48.
6. Garcia-Molina, L., et al. (2020). "Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: a systematic review and meta-analysis." European journal of nutrition 59(4): 1313-1328.
7. Gray, A. and R. J. Threlkeld (2015). "Nutritional recommendations for individuals with diabetes."
8. Green, H., et al. (2021). "The social determinants of health and health outcomes among adults during the COVID‐19 pandemic: A systematic review." Public Health Nursing 38(6): 942-952.
9. Guizar-Heredia, R., et al. (2023). "A New Approach to Personalized Nutrition: Postprandial Glycemic Response and its Relationship to Gut Microbiota." Archives of Medical Research.
10. Guo, Y., et al. (2020). "The role of nutrition in the prevention and intervention of type 2 diabetes." Frontiers in bioengineering and biotechnology 8: 575442.
11. Johnson, R. J., et al. (2024). "The fructose survival hypothesis as a mechanism for unifying the various obesity hypotheses." Obesity 32(1): 12-22.
12. Lenzi, F. and T. Filardi (2023). "Social determinants of vulnerabilities in type 2 diabetes: a call to action." Journal of Endocrinological Investigation 46(4): 841-844.
13. Lingvay, I., et al. (2022). "Obesity management as a primary treatment goal for type 2 diabetes: time to reframe the conversation." The Lancet.
14. Little, M., et al. (2022). "Promoting healthy food access and nutrition in primary care: a systematic scoping review of food prescription programs." American Journal of Health Promotion 36(3): 518-536.
15. Makori, J. O. (2023). "Improving Self-Management of Diabetes with Culturally Sensitive Interventions."
16. Park, J. C., et al. (2023). "Association of Sustained Low or High Income and Income Changes With Risk of Incident Type 2 Diabetes Among Individuals Aged 30 to 64 Years." JAMA Network Open 6(8): e2330024-e2330024.
17. Petroni, M. L., et al. (2021). "Nutrition in patients with type 2 diabetes: Present knowledge and remaining challenges." Nutrients 13(8): 2748.
18. Shahidi, F. and Y. Pan (2022). "Influence of food matrix and food processing on the chemical interaction and bioaccessibility of dietary phytochemicals: A review." Critical Reviews in Food Science and Nutrition 62(23): 6421-6445.
19. Short, E., et al. (2023). "An integrated approach to address diabetes in the context of food insecurity: Delivering health study protocol." Contemporary Clinical Trials Communications 33: 101139.
20. Silva, P., et al. (2023). "Nutrition and Food Literacy: Framing the Challenges to Health Communication." Nutrients 15(22): 4708.
21. Świątoniowska-Lonc, N., et al. (2021). "Psychosocial determinants of treatment adherence in patients with type 2 diabetes–a review." Diabetes, Metabolic Syndrome and Obesity: 2701-2715.
22. Toi, P. L., et al. (2020). "Preventive role of diet interventions and dietary factors in type 2 diabetes mellitus: an umbrella review." Nutrients 12(9): 2722.
23. Unnikrishnan, R., et al. (2017). "Type 2 diabetes: demystifying the global epidemic." Diabetes 66(6): 1432-1442.
24. Yannakoulia, M., et al. (2007). "Effectiveness of an intensive nutritional intervention in patients with type 2 diabetes mellitus: results from a pilot study." The Review of Diabetic Studies: RDS 4(4): 226.

Most read articles by the same author(s)