Impact of integrative therapies on glycemic control in type 1 diabetes: a systematic review and global research landscape

Background: Type 1 diabetes mellitus (T1DM) requires lifelong insulin therapy due to autoimmune destruction of pancreatic β-cells, the difficulty of achieving ideal glycemic control despite advancements in conventional care has led to a rise interest in alternative and integrative medicine (CIM) practices like naturopathy, yoga, and Ayurveda. Objective: This systematic review and meta-analysis aimed to evaluate the effects of integrative therapies on glycemic control in individuals with T1DM and to map the global research landscape through bibliometric analysis. Methods: Following PRISMA, a thorough literature search was carried out in PubMed, Scopus, Embase, and Google Scholar. Included were studies evaluating CIM interventions for T1DM, such as yoga, naturopathy, and Ayurvedic treatments. Both qualitative and quantitative methods were used to synthesise the data, and bibliometric studies were conducted to evaluate country-level output, temporal trends, institutional contributions, and keyword network analysis. Results: Out 612 screened records, 12 studies met inclusion criteria for qualitative and quantitative analysis. Integrative therapies showed adjunctive benefits to insulin therapy, including improved glycemic control, insulin sensitivity, stress reduction and quality of life. After 2023, bibliometric study showed a growing research trend, In the context of citation impact, Italy and Vietnam are leading, whereas India leads in publications. Keyword network analysis revealed strong associations between integrative practices, particularly yoga and lifestyle modification and glycemic outcomes. Conclusion: Integrative therapies appear to be promising alternative in the management of T1DM, supporting glycemic control and holistic well-being. However, larger multicenter clinical trials are required to strengthen the evidence base and support their integration into standard diabetes care frameworks. Broader clinical integration, rigorous multicentric trials, and greater alignment with national AYUSH policies are recommended to optimize T1DM management in India and potentially enhance outcomes globally.