Nutrition Interventions Improve Glycemic Control Among People With Type 2 Diabetes in Low‐ and Middle‐Income Countries. A Systematic Review

INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.