Abstract

EVIDENCE-BASED NUTRITION PATTERNS AND LIFESTYLE COUNSELLING IN TYPE 2 DIABETES CARE: BRIDGING GAPS WITH PERSONALIZED, DIGITAL, AND LMIC-TAILORED INNOVATIONS – A SYSTEMATIC REVIEW

Pillarikuppam Pavani, Anusha Konamsetti, G. Bhavya, D. Thilak, Niraj Kumar,

Abstract

Type 2 diabetes (T2D) affects over 500 million people globally, with India facing 11-15% prevalence amid rapid urbanization and lifestyle shifts. while RCTs endorse low-glycemic index with Mediterranean low-carbohydrate and plant-based diets for HbA1c reductions of 0.5-1.2%, weight loss, and cardiovascular benefits. persistent gaps include poor long-term adherence (>40% dropout), unaffordable Low- and Middle-Income Countries adaptations (e.g., olive oil, nuts), and limited personalization for genetic/ethnic factors like key proteincoding gene located on chromosome 10q25.2–q25.3 variants. This PROSPERO-registered systematic review synthesizes 2023-2026 RCTs, network meta-analyses and cohorts (n>50 trials) from PubMed, Embase, Cochrane, and grey literature up to January 2026, evaluating glycaemic control, adherence, costeffectiveness, and quality of life via GRADE-rated metaanalyses; LGI-Mediterranean hybrids excelled in Low- and Middle-Income Countries with digital interventions (apps, wearables) enhancing adherence by 25-35% through real-time feedback. We propose hybrid AI-driven models for Indian contexts—culturally adapted low-glycaemic index. plates featuring millets and lentils, pharmacogenomics-integrated mobile apps, and rural tele-counselling—leveraging predictive analytics for relapse prevention and pharmacoeconomic gains Incremental Cost-Effectiveness Ratio less than $500 per Quality-Adjusted Life Year), thereby bridging evidence-to-practice gaps with scalable, equity-focused innovations to mitigate Type 2 diabetes epidemic.

Keywords: Network meta-analyses (NMAs), Type 2 diabetes (T2D) ,low-glycemic index (LGI).