Research Progress on Lifestyle Intervention for Type 2 Diabetes

Abstract

The prevalence of type 2 diabetes (T2DM) is continuously increasing worldwide and domestically. Most patients are newly diagnosed cases. This disease can induce multiple systemic complications. Lifestyle intervention is a primary intervention method recommended in the 2024 edition of the diabetes prevention and treatment guidelines. For patients with prediabetes, a 6-month lifestyle intervention should be implemented first, and if the effect is not satisfactory, drug treatment should be initiated. The onset of T2DM is influenced by uncontrollable factors such as genetics and age, as well as controllable risk factors such as obesity, diet, exercise, sleep, and psychology. Various lifestyle interventions can effectively improve metabolic indicators such as glycosylated hemoglobin, blood pressure, blood lipids, and body weight, reduce insulin resistance, decrease the use of hypoglycemic drugs, and delay complications. However, there are common problems such as poor intervention compliance and the loss of efficacy after interruption. Improving long-term adherence is the core clinical challenge. In the aspect of exercise intervention, both aerobic and resistance exercises can improve glycolipid metabolism. The combined training of the two has a better effect on improving pancreatic β-cell function, cardiopulmonary function, and cognitive function. Abdominal obesity and small thigh circumference groups benefit more from exercise. Morning fasting exercise is more beneficial than post-meal exercise in reducing glycosylated hemoglobin and visceral fat. Dietary intervention is the core of controlling blood sugar. Balanced diets such as those based on whole grains, fresh fruits, and soy products, plant-based diets, Mediterranean diets, and low-carbohydrate diets can all reduce the risk of disease and improve metabolic indicators. However, the Mediterranean diet has insufficient long-term adherence in the elderly population. Clinically, it is necessary to formulate easy-to-persist dietary plans based on patients’ preferences. In terms of sleep, 7-8 hours of daily sleep is the optimal duration. Insomnia, abnormal sleep duration, and obstructive sleep apnea all increase the risk of T2DM. Fish oil n-3 polyunsaturated fatty acids can regulate the circadian rhythm and improve sleep. Melatonin should be used with caution as it can reduce insulin sensitivity. Continuous airway positive pressure ventilation can assist in improving blood sugar and kidney indicators in patients with sleep apnea and coexisting sleep disorders. Psychologically, depression and anxiety are genetically associated with T2DM. Community comprehensive care and cognitive behavioral therapy can alleviate negative emotions and improve the compliance of blood sugar self-management. In summary, multi-dimensional lifestyle interventions in exercise, diet, sleep, and psychology have significant value in the prevention and treatment of T2DM. Future research should focus on individualized intervention plans to address the practical problem of insufficient long-term adherence of patients.