Efficacy of lifestyle interventions in patients with type 2 diabetes: A systematic review and meta-analysis

• Diet modification and physical activity are used for the evaluation of type 2 diabetes.
• DIET intervention shows improvement in HbA1c, blood pressure, and the quality of life.
• Nutrition had a significant impact on the QOL by reducing cardiovascular risk.

BackgroundThe current meta-analysis evaluated the outcomes of various lifestyle interventions, including diet modifications (DIET), physical activity (PA), and patient education (EDU) in reducing the risk of cardiovascular disease in patients with type 2 diabetes.MethodsRandomized clinical trials comparing lifestyle intervention with “usual care” (control) in type 2 diabetes patients were hand-searched from medical databases by two independent reviewers using the terms “diabetes, cardiovascular risk, lifestyle, health education, dietary, exercise/physical activities, and behavior intervention”.ResultsOf the 235 studies identified, 17 were chosen for the meta-analysis. The average age of patients ranged from 50–67.3 years. Results reveal no significant difference between the groups, with respect to BMI, while PA and DIET yielded a greater reduction in HbA1c. Significant reduction in both systolic and diastolic pressures in the DIET group, and diastolic pressure in the PA group, was observed. HDL-c in the DIET group was significantly higher than the control group, while no change in LDL-c levels, was seen in all three intervention subtypes. There was no difference between the EDU vs. the control group in terms of HbA1c, blood pressure or HDL-c and LDL-c.ConclusionDIET intervention showed an improvement in HbA1c, systolic/diastolic blood pressure and HDL-c, with an exception of LDL-c and BMI, suggesting that nutritional intervention had a significant impact on the quality of life by reducing the cardiovascular risk in type 2 diabetes patients.