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.
| Original language | English (US) |
|---|---|
| Article number | 133 |
| Journal | Communications Medicine |
| Volume | 3 |
| Issue number | 1 |
| DOIs | |
| State | Published - Dec 2023 |
Funding
We thank Hugo Fitipaldi, Esther Gonz\u00E1lez-Padilla, Alisha Sha, and Jiaxi Yang for attending some of the working group meetings and/or for reviewing some of the abstracts. The Precision Medicine in Diabetes Initiative (PMDI) was established in 2018 by the American Diabetes Association (ADA) in partnership with the European Association for the Study of Diabetes (EASD). The ADA/EASD PMDI includes global thought leaders in precision diabetes medicine who are working to address the burgeoning need for better diabetes prevention and care through precision medicine (Nolan et al.). This Systematic Review is written on behalf of the ADA/EASD PMDI as part of a comprehensive evidence evaluation in support of the 2nd International Consensus Report on Precision Diabetes Medicine (Tobias et al.). The ADA/EASD Precision Diabetes Medicine Initiative, within which this work was conducted, has received the following support: The Covidence license was funded by Lund University (Sweden), for which technical support was provided by Maria Bj\u00F6rklund and Krister Aronsson (Faculty of Medicine Library, Lund University, Sweden). Administrative support was provided by Lund University (Malm\u00F6, Sweden), the University of Chicago (IL, USA), and the American Diabetes Association (Washington D.C., USA). The Novo Nordisk Foundation (Hellerup, Denmark) provided grant support for in-person writing group meetings (PI: L Phillipson, University of Chicago, IL). D.B. was supported through an Early Career Research grant (ECR/2017/000640) from Science and Engineering Research Board (SERB), India. J.M. was partially supported by funding from the American Diabetes Association (7-21-JDFM-005) and the National Institutes of Health (P30 DK40561 and UG1 HD107691). R.J.F.L. received support through NNF18CC0034900; NNF20OC0059313 (Laureate Award), and DNRF161 (Chair). We thank Hugo Fitipaldi, Esther Gonz\u00E1lez-Padilla, Alisha Sha, and Jiaxi Yang for attending some of the working group meetings and/or for reviewing some of the abstracts. The Precision Medicine in Diabetes Initiative (PMDI) was established in 2018 by the American Diabetes Association (ADA) in partnership with the European Association for the Study of Diabetes (EASD). The ADA/EASD PMDI includes global thought leaders in precision diabetes medicine who are working to address the burgeoning need for better diabetes prevention and care through precision medicine (Nolan et al.13). This Systematic Review is written on behalf of the ADA/EASD PMDI as part of a comprehensive evidence evaluation in support of the 2nd International Consensus Report on Precision Diabetes Medicine (Tobias et al.12). The ADA/EASD Precision Diabetes Medicine Initiative, within which this work was conducted, has received the following support: The Covidence license was funded by Lund University (Sweden), for which technical support was provided by Maria Bj\u00F6rklund and Krister Aronsson (Faculty of Medicine Library, Lund University, Sweden). Administrative support was provided by Lund University (Malm\u00F6, Sweden), the University of Chicago (IL, USA), and the American Diabetes Association (Washington D.C., USA). The Novo Nordisk Foundation (Hellerup, Denmark) provided grant support for in-person writing group meetings (PI: L Phillipson, University of Chicago, IL). D.B. was supported through an Early Career Research grant (ECR/2017/000640) from Science and Engineering Research Board (SERB), India. J.M. was partially supported by funding from the American Diabetes Association (7-21-JDFM-005) and the National Institutes of Health (P30 DK40561 and UG1 HD107691). R.J.F.L. received support through NNF18CC0034900; NNF20OC0059313 (Laureate Award), and DNRF161 (Chair).
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Internal Medicine
- Epidemiology
- Medicine (miscellaneous)
- Assessment and Diagnosis
