{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:51:18Z","timestamp":1781805078825,"version":"3.54.5"},"reference-count":39,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Catalyst Grant"],"award-info":[{"award-number":["Catalyst Grant"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Prediabetes is a precursor of type 2 diabetes mellitus (T2DM), and lifestyle modifications are key preventive strategies. Primary care is central to prevention efforts, including screening, diagnosis, and follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aimed to evaluate the effectiveness of lifestyle interventions delivered in primary care to patients at elevated risk of developing T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES<\/jats:title>\n                    <jats:p>We searched Medline and Embase from inception to 28 March 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY SELECTION<\/jats:title>\n                    <jats:p>We screened 639 records and included 14 eligible studies of lifestyle-based diabetes prevention programs. Eligible participants had prediabetes or high diabetes risk scores, and interventions were delivered in primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA EXTRACTION<\/jats:title>\n                    <jats:p>Outcomes included diabetes incidence, glycemic and anthropometric indicators, physical activity, and diet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SYNTHESIS<\/jats:title>\n                    <jats:p>Pooled mean differences (MD) were estimated using inverse variance methods; leave-one-out cross-validation (LOOCV) addressed heterogeneity (&amp;gt;50%). Meta-analysis found no significant effects on diabetes incidence (relative risk 0.82; 95% CI 0.65\u20131.02), and pooled MD on HbA1c (MD \u22120.41, 95% CI \u22120.94 to 0.12), fasting glucose, 2-h glucose, body weight, BMI, waist circumference (MD \u22121.13, 95% CI \u22122.40 to 0.13), or systolic and diastolic blood pressure. LOOCV identified one study driving heterogeneity in several outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS<\/jats:title>\n                    <jats:p>English-only publications may reduce generalizability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This review found no significant differences in diabetes incidence or other key indicators of T2DM, with certainty of evidence varying from moderate to low. Future studies should test integrated screening, referral, and social support strategies in routine care for high-risk groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-1877","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T16:13:37Z","timestamp":1777047217000},"page":"1124-1133","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["The Effectiveness of Diabetes Prevention Programs Delivered in Primary Care for Individuals With Prediabetes or at Risk of Developing Type 2 Diabetes: A Systematic Review and Meta-analysis"],"prefix":"10.2337","volume":"49","author":[{"given":"Jinfan","family":"Qiang","sequence":"first","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto 1 , Toronto, Ontario, Canada"},{"name":"Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital 2 , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maduomethaa","family":"Pathmaraj","sequence":"additional","affiliation":[{"name":"Mary Heersink School of Global Health and Social Medicine, McMaster University 3 , Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Lo","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, University of Waterloo 4 , Waterloo, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Uleryk","sequence":"additional","affiliation":[{"name":"E.M. Uleryk Consulting, Mississauga 5 , Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Huszti","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto 1 , Toronto, Ontario, Canada"},{"name":"Biostatistics Department, University Health Network 6 , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lusine","family":"Abrahamyan","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto 1 , Toronto, Ontario, Canada"},{"name":"Toronto General Hospital Research Institute, University Health Network 7 , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1841-9347","authenticated-orcid":false,"given":"Andrew D.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, University of Toronto 1 , Toronto, Ontario, Canada"},{"name":"Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital 2 , Toronto, Ontario, Canada"},{"name":"Department of Family and Community Medicine, St. Michael\u2019s Hospital 8 , Toronto, Ontario, Canada"},{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Toronto 9 , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"2026061812573351300_B1","doi-asserted-by":"crossref","first-page":"S62","DOI":"10.2337\/dc10-S062","article-title":"Diagnosis and classification of diabetes mellitus","volume":"33","author":"American Diabetes Association","year":"2010","journal-title":"Diabetes Care"},{"key":"2026061812573351300_B2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2337\/dci23-0085","article-title":"Economic costs of diabetes in the U.S. in 2022","volume":"47","author":"Parker","year":"2024","journal-title":"Diabetes Care"},{"key":"2026061812573351300_B3","unstructured":"Public Health Agency of Canada\n          . 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