Effectiveness of Lifestyle Interventions in Preventing Type 2 Diabetes in Primary Care Settings: A Systematic Review

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) and prediabetes are significant social health issues in Saudi Arabia, which are caused by a rapid increase in urbanization, a sedentary lifestyle, and a change in diet. The lifestyle changes, such as changes in the diet, physical activity, and behavior support have been globally recognized as cost-effective first-line interventions to prevent the onset of the disease. Primary healthcare centers (PHCs) can provide an easy point of access to the provision of these ongoing interventions to at-risk populations. Objective: This systematic review will combine existing evidence on the effectiveness of lifestyle interventions provided in primary care settings in Saudi Arabia in preventing or delaying the progression of T2DM in adults. Methods: A systematic literature review was done using databases including PubMed, Scopus, the Cochrane Library, and Web of Science of studies published between 2015 and 2026. The search was restricted to randomized controlled trials (RCTs) and quasi-experimental design studies that assessed the effects of lifestyle changes on glycemic and anthropometric variables in Saudi primary care settings. The extraction of data and the evaluation of its quality were carried out based on the PRISMA guidelines. Results: The evidence synthesized by 12 eligible studies suggests that culturally-modernized lifestyle programs can significantly enhance the metabolic outcomes. The results of the intervention groups demonstrated that participants with diabetes reduced their glycated hemoglobin (HbA1c) by 0.5% to 1.2% and experienced weight loss of clinical significance (3 to 5 per cent of baseline body weight) over 6 to 18 months. Conclusion: Lifestyle interventions that are included in the primary healthcare system of Saudi Arabia are effective, feasible and culturally adaptable. To enhance the effectiveness of such programs, primary care facilities need to have more access to multidisciplinary resources, including specialized dietitians and structured online follow-ups.