Bahari Nor Izyani, Ahmad Norfazilah, Mahmud Muhammad Hilmi, Baharom Mazni, Amir Siti Maisara, Peng Chua Su, Hassan Mohd Rohaizat, Nawi Azmawati Mohammed
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia.
J Prev (2022). 2023 Feb;44(1):105-125. doi: 10.1007/s10935-022-00707-x. Epub 2022 Sep 21.
Primary prevention of type 2 diabetes mellitus (T2DM) is possible in at-risk populations, and prevention programmes have been shown to be effective in real-world scenarios. Despite this evidence, diabetes prevalence has tripled in recent decades and is expected to reach 700 million patients by 2045, making it one of the leading causes of death globally. This review is aimed at identifying the issues and challenges in the primary prevention of T2DM.
Scopus, Web of Science, PubMed and Ovid MEDLINE were systematically searched for published articles. Articles were screened based of inclusion and exclusion criteria. The inclusion criteria were: (1) published in 2010-2020, (2) full original article, (3) written in English, (4) qualitative, mixed-methods article, observational or interventional study. The exclusion criteria were: (1) animal study, (2) in vivo/in vitro study, (3) type 1 diabetes or gestational DM and (4) conference abstract, book chapter, report, and systematic review. Eligible articles were assessed using Mixed Methods Appraisal Tool (MMAT) by three assessors.
A total of 11 articles were selected for qualitative synthesis from the initial 620 articles. The issues and challenges seen in T2DM primary prevention followed three themes: healthcare program (sub-themes: lack of resources, community partnership, participation, health literacy), health provider (sub-themes: lack of implementation, health care staff, collaboration, availability), individual (sub-themes: awareness, communication, misbehaviour, family conflict).
Factors relating to healthcare programmes, health providers, and individual issues are the main challenges in T2DM primary prevention. By establishing sustainable preventative initiatives that address these issues and challenges in the primary prevention of T2DM, a reduction in T2DM prevalence could be achievable.
2型糖尿病（T2DM）的一级预防在高危人群中是可行的，并且预防计划已被证明在现实场景中是有效的。尽管有这些证据，但近几十年来糖尿病患病率增长了两倍，预计到2045年将达到7亿患者，使其成为全球主要死因之一。本综述旨在确定T2DM一级预防中的问题和挑战。
系统检索了Scopus、科学网、PubMed和Ovid MEDLINE上发表的文章。根据纳入和排除标准筛选文章。纳入标准为：（1）2010 - 2020年发表；（2）完整的原创文章；（3）英文撰写；（4）定性、混合方法文章、观察性或干预性研究。排除标准为：（1）动物研究；（2）体内/体外研究；（3）1型糖尿病或妊娠期糖尿病；（4）会议摘要、书籍章节、报告和系统评价。由三名评估者使用混合方法评估工具（MMAT）对符合条件的文章进行评估。
从最初的620篇文章中总共筛选出11篇文章进行定性综合分析。T2DM一级预防中出现的问题和挑战遵循三个主题：医疗保健计划（子主题：资源缺乏、社区伙伴关系、参与、健康素养）、医疗服务提供者（子主题：缺乏实施、医护人员、协作、可及性）、个体（子主题：意识、沟通、行为不当、家庭冲突）。
与医疗保健计划、医疗服务提供者和个体问题相关的因素是T2DM一级预防中的主要挑战。通过建立可持续的预防措施来解决T2DM一级预防中的这些问题和挑战，有可能降低T2DM的患病率。
