Evaluation of Interventions for Primary Prevention of Type 2 Diabetes in At-Risk Subjects in Africa : A Systematic Review

Abstract

The objective of this systematic review is to provide an up-to-date review of research on primary prevention interventions for type 2 diabetes in adults in Africa. An electronic search for literature (PubMed, Scopus, Cochrane, African journal on line and Pro- QuestCentral) was conducted. A total of nine articles were selected. Primary prevention interventions were rare. Although the recent results of primary prevention interventions for type 2 diabetes in at-risk adults are not systematically measured, primary prevention is an important avenue in the management of type 2 diabetes because of the potential for improved glucose metabolism, altered insulin sensitivity, and reduced inflammatory markers. The research question for this study was: In at-risk or prediabetic or type 2 diabetic individuals, is adoption of a healthy diet and/or regular physical activity more beneficial in delaying the onset of biologically modifiable risk factors or reducing the incidence of type 2 diabetes? Interventions were based on nutrition or physical activity education or diet modification sessions. Results showed an improvement in physical activity level and dietary restriction with p = 0.03, followed by a decrease in systolic blood pressure OR = - 4.65 mmHg (-9.18; - 0.12) with p = 0.04 and a decrease in diastolic blood pressure OR = -3.30 mmHg (- 5.35; 61, 26) with p = 0.002. In addition, maximum walking speed had increased by 15% compared to the control group. The results also showed a decreased risk of developing abnormal glucose metabolism OR = 0.52 (0.27; 0.99). This systematic review could help to better guide type 2 diabetes prevention interventions in Africa.