Lifestyle Modification Programs and Interventions on Prediabetes in Saudi Arabia: A Systematic Scoping Review

Nahla Mohammed Bawazeer, Clinical Nutrition Program, Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Abeer Salman Alzaben, Clinical Nutrition Program, Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Elizabeth Dodge, Applied Nutrition Graduate Program, College of Professional Studies, University of New England, 716 Stevens Ave, Portland, ME, 04103, USA.
Amelia J. Baker, Department of Pediatric Endocrinology and Diabetes, Maine Health, Portland, ME, 04102, USA.
Nada Benajiba, Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, 14000, Rabat, Kenitra, Morocco.
Basil H. Aboul-Enein, College of Arts & Sciences, Health & Society Program, University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, MA, 02747, USA. baboulenein@umassd.edu.

Abstract

Prediabetes is characterized by elevated blood glucose and glycated hemoglobin levels (HbA1c) that remain below the diagnostic threshold for type 2 diabetes. It increases the risk of diabetes, all-cause mortality, and chronic diseases. Saudi Arabia has one of the highest global diabetes rates. This review evaluates interventions targeting prediabetes in Saudi Arabia and provides recommendations based on their effectiveness. A systematic scoping review was conducted across 12 databases for intervention studies published through March 2024. Study quality was assessed using the Academy of Nutrition and Dietetics Evidence Analysis Library Manual Quality Criteria. Six lifestyle intervention studies in Saudi Arabia, lasting from six months to over a year, were analyzed. All demonstrated good quality with minimal selection bias. Intervention groups showed significant improvements in metabolic syndrome components, fasting glucose, Homeostatic Model Assessment of Insulin Resistance, and HbA1c. One study reported prediabetes reversal and type 2 diabetes remission following lifestyle modifications. Multi-center interventions combining education, counseling, and physical activity were more effective than general advice alone in improving metabolic outcomes. Lifestyle modifications are an effective first-line approach for prediabetes management. In addition to the health benefits associated with improving glycemic control, lifestyle modification has the potential to reduce individual and public healthcare costs associated with prediabetes. This review supports the efficacy of lifestyle modification programs, conducted in Saudi Arabia, in controlling or reversing prediabetes.