Effectiveness of Lifestyle and Pharmacological Interventions in Managing Type 2 Diabetes Mellitus – A Systematic Review
DOI:
https://doi.org/10.61919/f6867e87Keywords:
Type 2 diabetes mellitus, lifestyle intervention, pharmacological therapy, glycemic control, systematic review, meta-analysisAbstract
Background: Type 2 diabetes mellitus is a progressive metabolic disorder associated with substantial morbidity, premature mortality, and rising healthcare expenditure worldwide. Lifestyle modification and pharmacological therapy are both central to disease management, yet the relative and additive effects of these approaches on glycemic control have been reported inconsistently across studies. Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of lifestyle interventions, pharmacological therapies, and their combination in improving glycemic control among adults with type 2 diabetes mellitus. Methods: A PRISMA 2020–compliant systematic review and meta-analysis was conducted using PubMed/MEDLINE, Scopus, Web of Science, Embase, and the Cochrane Library, covering the period from January 2010 to June 2024. Randomized controlled trials and comparative studies enrolling adults with type 2 diabetes mellitus and reporting glycemic outcomes following lifestyle interventions, pharmacological therapies, or both were eligible. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Random-effects meta-analyses were performed to estimate pooled mean differences for glycated hemoglobin (HbA1c) and fasting blood glucose. Results: Eight studies met criteria for qualitative synthesis, and five studies comprising more than 20,000 participants were included in the quantitative meta-analysis. Compared with standard care, lifestyle interventions were associated with a significant reduction in HbA1c (−0.61%, 95% CI −0.79 to −0.43; p<0.001), with moderate heterogeneity (I²=48%). The addition of pharmacological therapy to lifestyle intervention was associated with a further reduction in HbA1c (−0.32%, 95% CI −0.51 to −0.13). Lifestyle interventions were also associated with a significant reduction in fasting blood glucose (−0.41 mmol/L, 95% CI −0.55 to −0.28). Conclusion: Lifestyle interventions are associated with clinically meaningful improvements in glycemic control in adults with type 2 diabetes mellitus, and the addition of pharmacological therapy provides further incremental benefit. These findings support the use of integrated lifestyle–pharmacological strategies for optimizing glycemic management.
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Copyright (c) 2025 Syed Ahsan Abrar, Ali Basim, Basit Shaukat, Mariyam Usman, Hira Rehan, Qudsia Saad (Author)
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