Nutrition Interventions Improve Glycemic Control Among People With Type 2 Diabetes in Low- and Middle-Income...

The incidence of Type II diabetes (T2D) is increasing rapidly in low- and middle-income countries (LMICs). Dedicated nutrition interventions may be a low-cost low-burden method to improve glycemic control. A systematic review was conducted to explore dedicated nutrition interventions in LMICs for people with T2D.

An intentionally broad search of Pubmed, ProQuest, and Scopus databases was conducted with multiple terms for diabetes, nutrition, and LMICs. The study authors screened 6778 unique abstracts for inclusion criteria. Following a thorough screening procedure, 37 publications reporting on 38 interventions were included for data extraction.

The interventions were conducted in the Middle East and North Africa (n = 14), Southeast Asia (n = 7) and East Asia (n = 7), Africa (n = 5), South Asia (n = 3), and Latin and South America (n = 2), including a total of 2950 participants (55% women). Intervention duration was highly varied (18 ± 13 weeks), and led to a decrease in glycated hemoglobin (8.6% to 7.4%, Cohen's d = 1.0) and fasting glucose (172 to 135 mg/dL, Cohen's d = 1.3) in most studies. Intervention adherence was 87 ± 15%; parameters such as session duration, intensity, mode, setting, and study reporting varied greatly between trials and were often incompletely reported.

Nutrition interventions in LMICs show great potential for improving glycemic control among people with T2D, although little research has been conducted in low-income countries. More research should be conducted with standardized reporting procedures to develop and test evidence-based strategies.