“Preventing the Progression: The Power of Lifestyle Interventions in Prediabetic Individuals—A Systematic Review”

Abstract

Background and Aims: Prediabetes—a reversible metabolic condition characterized by impaired fasting glucose, elevated HbA1c, or reduced glucose tolerance—is a major precursor to type 2 diabetes mellitus (T2DM), especially in high-risk populations like India. This review evaluates the impact of culturally tailored lifestyle interventions in preventing type 2 diabetes in adults with prediabetes. Methods: This PRISMA-compliant systematic review (PROSPERO: CRD420251085667) included RCTs from 2020 to 2025 on adults (≥18 years) with prediabetes. It assessed lifestyle interventions—diet, exercise, yoga, and behavioral support—using the Jadad scale and Downs & Black checklist. Results: Six high-quality RCTs demonstrated significant improvements in glycemic parameters, cardiometabolic profiles, and reductions in diabetes incidence. Yoga-based protocols yielded notable declines in HbA1c and stress biomarkers. Dietary counseling and formula diets achieved normoglycemia and metabolic benefits independent of weight loss. Long-duration interventions also reduced frailty and disability risks, enhancing overall health outcomes. Conclusions: Culturally adapted lifestyle interventions show strong efficacy and scalability in reversing prediabetes and reducing progression to T2DM. Integration of such strategies into national diabetes prevention programs may enhance sustainable metabolic health and address the unique needs of high-risk populations.