Dimassi Ahmad, Lunnay Belinda, Aylward Paul, Tyndall Jessica, Ward Paul R
Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia
Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, South Australia, Australia.
BMJ Open. 2025 Jan 9;15(1):e089793. doi: 10.1136/bmjopen-2024-089793.
This systematic review aims to assess the available evidence on the prevention of type 2 diabetes mellitus (T2DM) among Middle Eastern (ME) populations residing in high-income countries (HICs). The review focuses on two key aspects: (1) evaluating the efficacy of interventions for improving health outcomes and (2) examining the barriers to and facilitators of the implementation and effectiveness of interventions.
Systematic review.
MEDLINE, ProQuest Central and Scopus were searched between 10 September 2023 and 10 October 2023.
Studies published in English from 2000 to 2023 involving ME populations residing in HICs who are prediabetic or at high risk of T2DM. Interventions included behavioural, pharmacological and educational strategies, with outcomes assessed in terms of diabetes incidence, lifestyle changes and healthcare utilisation, as well as barriers and facilitators of intervention effectiveness.
Data were extracted and synthesised based on study design, geographical location, participant characteristics, type of approach and key outcomes. A narrative synthesis was used to identify patterns in intervention effectiveness, barriers (eg, cultural and gender norms, language) and facilitators (eg, family support, religious considerations).
20 studies were included and categorised into two groups: interventional studies (randomised controlled trials and quasi-experimental designs) and qualitative and cross-sectional studies. Interventional studies demonstrated significant improvements in health outcomes, including weight loss, increases in physical activity and improved cardiometabolic markers. Qualitative studies revealed important insights into the sociocultural factors facilitating T2DM prevention that must be considered for effective interventions, including gender norms, family dynamics (relations, interactions, etc) and religious beliefs, with barriers including language, lack of health insurance, unaffordable financial costs and social isolation.
This systematic review highlights the effectiveness of culturally sensitive interventions in preventing T2DM among ME populations in HICs. It emphasises a need for co-designed, culturally appropriate interventions that involve people from ME populations in HIC with lived experience of T2DM, healthcare providers and community stakeholders.
PROSPERO, CRD42023457123.
本系统评价旨在评估关于居住在高收入国家（HICs）的中东（ME）人群预防2型糖尿病（T2DM）的现有证据。该评价聚焦于两个关键方面：（1）评估改善健康结局的干预措施的效果；（2）研究干预措施实施及有效性的障碍和促进因素。
系统评价。
于2023年9月10日至2023年10月10日期间检索了MEDLINE、ProQuest Central和Scopus数据库。
2000年至2023年期间以英文发表的研究，涉及居住在HICs的处于糖尿病前期或T2DM高风险的ME人群。干预措施包括行为、药物和教育策略，结局评估指标包括糖尿病发病率、生活方式改变、医疗保健利用情况，以及干预有效性的障碍和促进因素。
根据研究设计、地理位置、参与者特征、方法类型和关键结局提取并综合数据。采用叙述性综合分析来识别干预有效性、障碍（如文化和性别规范、语言）和促进因素（如家庭支持、宗教因素）中的模式。
纳入20项研究，分为两组：干预性研究（随机对照试验和准实验设计）以及定性和横断面研究。干预性研究表明健康结局有显著改善，包括体重减轻、身体活动增加和心脏代谢指标改善。定性研究揭示了对促进T2DM预防的社会文化因素的重要见解，这些因素对于有效的干预措施而言必须加以考虑，包括性别规范、家庭动态（关系、互动等）和宗教信仰，障碍包括语言、缺乏医疗保险、经济成本难以承受和社会隔离。
本系统评价突出了文化敏感型干预措施在预防HICs中ME人群T2DM方面的有效性。它强调需要共同设计、适合文化背景的干预措施，让来自HICs且有T2DM生活经历的ME人群、医疗保健提供者和社区利益相关者参与其中。
PROSPERO注册号：PROSPERO，CRD42023457123。
