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Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition

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A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: closed (30 September 2025) | Viewed by 20028

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Dr. Freya MacMillan

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School of Medicine, Translational Health Research Institute, Western Sydney University, Penrith, NSW 2153, Australia
Interests: marginalized populations; access to health; culturally and linguistically diverse groups; obesity; lifestyle interventions
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Special Issue Information

Dear Colleagues,

Diabetology (ISSN 2673-4540) is an international, open access journal. In this Special Issue of Diabetology, we invite researchers to submit their works on the development, testing, and implementation of lifestyle behavior interventions into practice for the prevention and management of diabetes. The instructions on how to proceed with writing will be available on a dedicated web page. Research areas may include (but are not limited to) the following:

Studies of those with or at risk of diabetes to understand their lifestyle behaviors and inform the development of interventions;
Qualitative, quantitative, or mixed-method studies to evaluate novel lifestyle behavior interventions for diabetes prevention or management;
Implementation science studies examining the translation of lifestyle behavior interventions for diabetes prevention and/or management into community, healthcare, workplace, or other settings.

We invite you to submit original research articles, systematic reviews, narrative reviews, or short communications on this topic. We look forward to your contributions.

Dr. Freya MacMillan
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diabetology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

lifestyle program
lifestyle intervention
implementation science
qualitative
quantitative
mixed methods
diabetes prevention
diabetes management
diet
physical activity
weight loss
weight maintenance

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Published Papers (10 papers)

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Research

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15 pages, 985 KB

Open AccessArticle

Are There Mental Health Benefits for Those Who Deliver Peer Support? A Mobile App Intervention for Adults with Type 1 Diabetes

by Debbie Lam, Diana Sherifali, Frances S. Chen and Tricia S. Tang

Diabetology 2025, 6(10), 116; https://doi.org/10.3390/diabetology6100116 - 9 Oct 2025

Viewed by 426

Abstract

Background/Objectives: Peer support offers a promising approach for improving psychosocial outcomes among adults with type 1 diabetes (T1D). However, research has focused largely on the recipients of peer support rather than the individuals who provide support. This pilot study investigates the impact of delivering support on diabetes distress and other secondary mental health outcomes (e.g., depressive symptoms, resilience, and perceived social support). Methods: This pre–post single-cohort study recruited 44 adults with T1D who underwent a six-hour Zoom-based peer supporter training program designed to equip them with support-related skills (asking open-ended questions, making reflections, expressing empathy). Of this group, 36 served as peer supporters for REACHOUT, a six-month mental health support intervention delivered via mobile app. Assessments were conducted at baseline and after six months and measured diabetes distress (Type 1 Diabetes Distress Scale), depressive symptomatology (Patient Health Questionnaire-8), resilience (Diabetes Strengths and Resilience Measure), and perceived social support. Unadjusted and adjusted linear mixed models were performed for each outcome measure of interest. Results: Peer supporters had a mean age of 41 ± 16 years, with a majority identifying as female (75%). At baseline, peer supporters had little to no diabetes distress (50%) and no to mild depressive symptomatology (72%). Mean scores at baseline for diabetes distress, depressive symptoms, resilience, and perceived social support were sustained at 6 months post-intervention. Conclusions: Among peer supporters whose diabetes distress scores start around the target range, ongoing maintenance of these levels may reflect a favorable outcome associated with delivering mental health support. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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23 pages, 284 KB

Open AccessArticle

Dietary Behaviors and Psychosocial Factors of People Managing Diabetes During Fasting: A Qualitative Study from Five US Muslim Communities

by Asma Mahd Ali, Olayinka O. Shiyanbola, Ejura Salihu, Salma Abdelwahab, James E. Bailey and Betty Chewning

Diabetology 2025, 6(10), 104; https://doi.org/10.3390/diabetology6100104 - 1 Oct 2025

Viewed by 610

Abstract

Objectives: This study sought to understand dietary behaviors among US Muslim people with Type 2 diabetes while managing diabetes and fasting during Ramadan, identify key psychosocial factors influencing behaviors, and examine how identified factors influence diet behaviors and health outcomes from the patient’s perspective. Methods: The study employed community-engaged research principles and qualitative research design. Twenty-two adult Muslim adults living with Type 2 diabetes for over 6 months participated in semi-structured one-on-one interviews. Participants were recruited from five US communities using purposive sampling. Three trained researchers used abductive coding, combining deductive and inductive approaches, to analyze the data. Results: Six main themes emerged from the data: (1) changes in dietary habits during Ramadan; (2) strong influence of religious, cultural and social practices on dietary behaviors; (3) variable self-efficacy in managing dietary behaviors; (4) impact of prior habits and current blood glucose status; (5) decision-making based on diabetes-related health outcomes (e.g., experiencing low blood sugar); (6) participants’ perception of Ramadan as an opportunity for sustainable behavioral changes. Conclusions: This study is among the first to document the dietary behaviors and key psychosocial factors influencing dietary behaviors and health outcomes for US Muslim people with Type 2 diabetes during Ramadan. The study suggests that interventions to improve diabetes control and promote diabetes remission among Muslims can benefit from cultural tailoring that draws on Ramadan religious, cultural and social practices to encourage sustainable behavioral change. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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16 pages, 627 KB

Open AccessArticle

Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program

by Alexandria M. Boykins, Satya Surbhi and James E. Bailey

Diabetology 2025, 6(7), 59; https://doi.org/10.3390/diabetology6070059 - 1 Jul 2025

Viewed by 716

Abstract

Background/Objectives: Recruiting and retaining low-income participants in community-based diabetes interventions remains a persistent challenge, particularly in medically underserved areas. This study describes engagement strategies and lessons learned recruiting for a 12-month pilot of a community-based, medically tailored nutrition program for diabetes remission and weight loss. Methods: A descriptive, exploratory mixed-methods study was performed to assess the effectiveness of recruitment and engagement strategies in the HEAL Diabetes program and identify areas for improvement. Recruitment and enrollment data were tracked utilizing recruitment logs and field notes. Descriptive statistics were used to analyze recruitment activity and retention rates, while qualitative analysis of fieldnotes identified key barriers and facilitators. Results: Among 83 eligible participants, 63 (75.9%) completed the in-person screening and 35 (55.6% enrollment rate) enrolled. Retention was high, with 30 completing the study. Participants were largely African American (97.1%), female (70.6%), average age of 59.8 years, with a household income below USD 49,000 (74.3%). Recruitment cycles achieved 87.5% of the target before budget constraints halted enrollment. Recruitment was hindered by limited clinical integration, social barriers and life demands, while facilitators to recruiting included trust, flexibility, and tangible support for participation. Conclusions: Conventional recruitment methods, including registry-based approaches, were insufficient for engaging underserved populations. Participant-centric strategies, emphasizing trust, practical support, and structural and cultural relevance, can help enhance enrollment and retention. Effective engagement in community-based diabetes interventions requires multifaceted approaches that address clinical, social, and structural barriers to participation. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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15 pages, 1111 KB

Open AccessArticle

Exploring the Role of AbaComplex in Managing Dysglycemia: Insights from a Randomized, Three-Arm, Placebo-Controlled Trial

by Elisabetta Schiano, Fabrizia Guerra, Federico Abate, Gaetano Piccinocchi, Gian Carlo Tenore and Ettore Novellino

Diabetology 2025, 6(2), 14; https://doi.org/10.3390/diabetology6020014 - 13 Feb 2025

Cited by 1 | Viewed by 1237

Abstract

Background: Dysglycemia, characterized by abnormal blood glucose levels, is a critical factor in the development of type 2 diabetes mellitus (T2DM) and its related complications. Among the traditional approaches to managing glucose homeostasis, supplementation with natural antidiabetic molecules stands out. Among these, abscisic acid (ABA), a naturally occurring compound abundant in unripe fruits, has shown potential for improving insulin sensitivity and glucose uptake. This study examines the effects of AbaComplex (ABAc), a nutraceutical derived from thinned nectarines, on glycemic control in individuals with dysglycemia, both alone and in combination with trivalent chromium, known for its role in increasing insulin signal. Methods: A three-arm, randomized, placebo-controlled trial was conducted over 3 months with 120 participants assigned to one of three groups: ABAc alone, ABAc with trivalent chromium (ABAc-Cr), or a placebo. Results: The results showed significant improvements in glycemic control in both the ABAc and ABAc-Cr groups compared to the placebo. Specifically, glycated hemoglobin decreased by 6.6% in the ABAc group and 11.3% in the ABAc-Cr group, while the placebo group showed a 4.3% increase. Both treatment groups also exhibited significant reductions in fasting glucose, insulin levels, and HOMA-IR. Nonetheless, the SF-12 questionnaire revealed marked improvements in physical and mental health, with the ABAc group alone demonstrating slightly greater improvements in certain quality-of-life measures. Conclusions: Overall, these findings underscore the effectiveness of ABAc supplementation as a valuable approach for managing dysglycemic conditions and early-stage T2D. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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13 pages, 689 KB

Open AccessEditor’s ChoiceArticle

Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study

by Maria Jesús Serrano-Ripoll, Rocío Zamanillo-Campos, Sofía Mira Martínez, Maria Antònia Fiol-deRoque, Narges Malih, Escarlata Angullo-Martínez and Ignacio Ricci-Cabello

Diabetology 2025, 6(1), 1; https://doi.org/10.3390/diabetology6010001 - 27 Dec 2024

Cited by 2 | Viewed by 1631

Abstract

Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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16 pages, 244 KB

Open AccessEditor’s ChoiceArticle

Translation and Impact of the National Diabetes Prevention Program in Two Rural Settings: Participant Outcomes, Individual Experiences, and Recommendations

by Jenifer J. Thomas, Bhibha M. Das, Lesley D. Lutes, Lacey Dickson, Parres Holliday, Brianna Adams and Hannah McNamee

Diabetology 2024, 5(7), 690-705; https://doi.org/10.3390/diabetology5070051 - 11 Dec 2024

Viewed by 3126

Abstract

Background/Objectives: The National Diabetes Prevention Program (National DPP) assists individuals with lifestyle change for type 2 diabetes risk reduction through education, skills, and support. To further understand program effectiveness, implementation research needs to consider influences on retention, effectiveness, and sustainability of the program in rural settings. The purpose of this study was to understand National DPP implementation in two rural workplace settings as well as the factors that influence program participation and outcomes. Methods: Individuals who met criteria for being at risk for developing type 2 diabetes participated in two National DPPs. The first program (Technology-Augmented DPP) occurred in 2016 with the goal of understanding the role of psychosocial factors in relation to National DPP outcomes, and quantitative data were obtained from 47 participants. Variables of interest included the Lifestyle-Health-Related Self-Concept questionnaire (HRSC), weight, and physical activity. The second program (Hybrid-Format DPP) occurred in 2022 with the goal of understanding individual participant experiences within the program by conducting a reflexive thematic analysis on data obtained during a semi-structured group interview with 3 participants. Results: In the Technology-Augmented DPP, Lifestyle-HRSC dimensions of nutrition, social support, avoiding diabetes, and problem solving were associated with weight, steps per day, and activity minutes. In the Hybrid-Format DPP, the generated themes included Frequency Matters, Rules of Engagement, Promoting Self-Efficacy, and Bridging the Intention-Behavior Gap. Conclusions: Based on this study, a focus on understanding and responding to context-specific and participant-focused National DPP implementation is the essential next step in National DPP research. Prevention programs and policies individualized to people and communities will improve participation and outcomes. The National DPP should consider how to evolve to the changing needs of at-risk individuals in rural and underserved areas. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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17 pages, 255 KB

Open AccessArticle

The Impact of Lifestyle Changes on the Prevalence of Prediabetes and Diabetes in Urban and Rural Indonesia: Results from the 2013 and 2018 Indonesian Basic Health Research (RISKESDAS) Survey

by Iche A. Liberty, Farid Kurniawan, Calysta N. Wijaya, Pradana Soewondo and Dicky L. Tahapary

Diabetology 2024, 5(6), 537-553; https://doi.org/10.3390/diabetology5060039 - 23 Oct 2024

Viewed by 5597

Abstract

(1) Background: Prediabetes represents reversible glycemic abnormalities between normal glucose regulation and diabetes. Indonesia has a high burden of non-communicable diseases, such as diabetes. This study aims to evaluate the impact of lifestyle changes on prediabetes and diabetes in rural and urban populations. (2) Methods: This is a repeated cross-sectional study, and data were obtained from Basic Health Research (RISKESDAS) in 2013 and 2018. (3) Results: The study found that urban populations who ate >3 days/week of vegetables had a lower proportion of prediabetes and diabetes. Rural populations with 2 days/week of vegetable consumption had a higher risk of prediabetes in 2018. From 2013 to 2018, urban and rural populations consumed excessive amounts of sweet food/drink, salty food, fatty/cholesterol/fried food, and meat/chicken/fish-based food with preservatives. In 2018, urban and rural populations who consumed sweet food/drink more than once daily had a higher risk of prediabetes and diabetes. The prevalence of active physical activity declined in normoglycemic individuals, while it increased in prediabetes and diabetes in urban and rural areas. In 2013, physical activity was a protective factor for prediabetes. (4) Conclusions: Lifestyle changes impacted prediabetes and diabetes prevalence. Further research is needed to promote healthy diets and lifestyle modifications. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

14 pages, 893 KB

Open AccessEditor’s ChoiceArticle

Lifestyle Medicine Case Manager Nurses for Type Two Diabetes Patients: An Overview of a Job Description Framework—A Narrative Review

by Giovanni Cangelosi, Stefano Mancin, Paola Pantanetti, Cuc Thi Thu Nguyen, Sara Morales Palomares, Federico Biondini, Marco Sguanci and Fabio Petrelli

Diabetology 2024, 5(4), 375-388; https://doi.org/10.3390/diabetology5040029 - 23 Aug 2024

Cited by 28 | Viewed by 4159

Abstract

Background: Lifestyle medicine (LM) is a contemporary scientific discipline with a multidisciplinary approach. Case Management offers a viable alternative for the care of patients with Type 2 Diabetes (T2D). This study aimed to identify the role and clinical applications of the lifestyle medicine case manager nurse (LMCMN) for T2D patients internationally and to analyze the role of specialist nurses in Italy through a narrative review. A secondary objective was to define a job description (JD) for a future Delphi method. Methods: A narrative review of the literature was conducted using PubMed/Medline, Scopus, and grey literature sources to analyze the international and Italian regulatory contexts. Subsequently, a JD for the LMCMN was developed for application in a future Delphi Study. Results: Nurses play a strategic role in managing T2D, and the LM approach has demonstrated strong evidence of effectiveness. This study developed a specific JD for the LMCMN suitable for both Italian and international contexts. Conclusions: The specific role of the LMCMN is still underdeveloped internationally. In the context of territorial assistance and chronic disease management, this professional is crucial for delivering quality care and shaping health policies that meet community needs. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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26 pages, 1197 KB

Open AccessReview

How the Salutogenic Pattern of Health Reflects in Type 2 Diabetes Mellitus: A Narrative Review

by Sandra Mijač, Ksenija Vitale, Karmen Lončarek and Goran Slivšek

Diabetology 2025, 6(11), 124; https://doi.org/10.3390/diabetology6110124 - 1 Nov 2025

Viewed by 266

Abstract

By 2045, approximately 783.2 million people are projected to be diagnosed with type 2 diabetes mellitus (T2DM). In addition, obesity is expected to affect up to 22% of the world’s population or one in four people. The diabesity epidemic, a worrying trend in which T2DM and obesity co-occur, is becoming increasingly evident and could be the most significant epidemic of non-communicable chronic diseases in human history. The salutogenic pattern of health, which emphasises well-being and resistance resources, could be a promising solution to address this alarming worldwide problem. The salutogenic pattern of health has numerous positive effects on the health of persons with T2DM. These include reducing the risk of it, lowering some biomarkers and laboratory parameters related to its control, and promoting a better lifestyle, ultimately improving the overall quality of life. The salutogenic pattern of health offers an effective and evidence-based approach to address the growing global problem of chronic non-communicable diseases such as T2DM. Integrating this theory into standard modern medical practice has the potential to significantly improve health outcomes and overall patient well-being, making it an important direction for modern medicine. Accordingly, the aim is to explore and analyse the salutogenic pattern of health associated with T2DM in order to prevent it, but also the better management of it. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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Other

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9 pages, 204 KB

Open AccessBrief Report

Diabetes-Specific Quality of Life Changes Associated with a Digital Support Intervention: A Study of Adults with Type 1 Diabetes

by Xiao-Qing Lu, Anthony T. Vesco and Tricia S. Tang

Diabetology 2025, 6(4), 28; https://doi.org/10.3390/diabetology6040028 - 8 Apr 2025

Viewed by 809

Abstract

Although digital platforms have gained popularity in the delivery of diabetes interventions, few models have focused on type 1 diabetes (T1D), offer different support delivery mechanisms, and involve peer and health professional-led support. TRIFECTA is a six-month multi-modal digital support intervention that includes a 24/7 peer texting group, an “ask-the-expert” web-based portal, and professional-led virtual group-based interactive sessions. This study examined diabetes-specific quality of life (DSQoL) changes following TRIFECTA. DSQoL was measured using Type 1 Diabetes and Life, a self-report survey that allows for subscale analysis in different age groups. Among 60 adults with type 1 diabetes, improvements were observed for overall diabetes-specific quality of life, primarily driven by the 26–45 years cohort. Subscale analysis found DSQoL improved for emotional experiences and daily activities for adults 26–45 years old, and social isolation improved for adults 46–60 years old. Full article

(This article belongs to the Special Issue Lifestyle Behavior Intervention for Diabetes Prevention and Management: 2nd Edition)

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