{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:37:17Z","timestamp":1790062637118,"version":"4.0.1"},"reference-count":51,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research, Development, and Innovation Fund of Hungary","award":["143383-FI17198"],"award-info":[{"award-number":["143383-FI17198"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Interventions for primary prevention are crucial in tackling type 2 diabetes (T2D) by offering a structured approach to implementing lifestyle modifications, such as community-based programs. The aim of this study was to demonstrate the effectiveness of primary prevention interventions in preventing or delaying the onset of T2D in the 28 EU member states (EU-28). The present systematic review is registered on PROSPERO (CRD42020219994), and it followed the PRISMA guidelines. Eligibility criteria comprised original interventional studies reporting incidence of T2D in member states of the EU-28. A total of 23,437 records were initially retrieved, of which 16 met the eligibility criteria for inclusion. These interventional studies, published between 2003 and 2021, provided data from Spain, the UK, Finland, the Netherlands, and Denmark. Thirteen studies were of low quality, two were moderate, and one was high-quality. Three studies focused solely on dietary interventions, twelve studies combined diet, physical activity, and lifestyle counseling, and one study applied repeated health checks with personalized feedback and lifestyle advice. Overall, 10 studies reported a significant reduction in T2D incidence exclusively among high-risk individuals following the interventions with HR: 0.4 (95% CI: 0.3\u20130.7) to 0.75 (95% CI: 0.58\u20130.96). Only a few studies reported that primary lifestyle interventions decreased T2D risk, thus limiting generalizability. While lifestyle improvements were noted on high-risk groups, significant risk reduction among healthy individuals was not observed. Multicomponent interventions combining dietary modifications, physical activity, and personalized lifestyle counseling were the most effective in reducing the incidence of T2D among high-risk populations in the EU-28.<\/jats:p>","DOI":"10.3390\/nu17061053","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T11:04:22Z","timestamp":1742209462000},"page":"1053","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Primary Prevention of Type 2 Diabetes Mellitus in the European Union: A Systematic Review of Interventional Studies"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6056-425X","authenticated-orcid":false,"given":"Carlos Alexandre Soares","family":"Andrade","sequence":"first","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"},{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8498-2421","authenticated-orcid":false,"given":"Szabolcs","family":"Lovas","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-7847","authenticated-orcid":false,"given":"Nour","family":"Mahrouseh","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghenwa","family":"Chamouni","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balqees","family":"Shahin","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"},{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7979-9859","authenticated-orcid":false,"given":"Eltayeb Omaima Awad","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"},{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7691-6080","authenticated-orcid":false,"given":"Abdu Nafan Aisul","family":"Muhlis","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"},{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7766-5164","authenticated-orcid":false,"given":"Diana Wangeshi","family":"Njuguna","sequence":"additional","affiliation":[{"name":"Medical Surgical Department, School of Nursing, Dedan Kimathi University of Technology, Nyeri 10143, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederico Epalanga Albano","family":"Israel","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"},{"name":"Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser","family":"Gammoh","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niyati","family":"Chandrika","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkunzi Conetta","family":"Atuhaire","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-256X","authenticated-orcid":false,"given":"Israa","family":"Ashkar","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de Val\u00e8ncia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoushka","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Charles","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Alzuhaily","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Almusfy","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"D\u00edaz Benavides","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. K.","family":"Alshakhshir","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8771-3975","authenticated-orcid":false,"given":"Orsolya","family":"Varga","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4028 Debrecen, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"ref_1","unstructured":"European Commission (2024, June 12). Knowledge for Policy: Health Promotion and Disease Prevention Knowledge Gateway. Diabetes preventions. Available online: https:\/\/knowledge4policy.ec.europa.eu\/health-promotion-knowledge-gateway\/diabetes-prevention_en."},{"key":"ref_2","unstructured":"International Diabetes Federation (2021). IDF Diabetes Atlas, International Diabetes Federation. [10th ed.]. Available online: https:\/\/diabetesatlas.org\/idfawp\/resource-files\/2021\/07\/IDF_Atlas_10th_Edition_2021.pdf."},{"key":"ref_3","unstructured":"European Union (2020). Health at a Glance: Europe 2020: State of Health in the EU Cycle, OECD Publishing."},{"key":"ref_4","unstructured":"Health and Environment Alliance (HEAL) (2014). Health Costs in the European Union\u2014How Much Is Related to EDCS, Health and Environment Alliance (HEAL). Available online: https:\/\/www.env-health.org\/IMG\/pdf\/18062014_final_health_costs_in_the_european_union_how_much_is_realted_to_edcs.pdf."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","article-title":"Epidemiology of Type 2 Diabetes\u2014Global Burden of Disease and Forecasted Trends","volume":"10","author":"Khan","year":"2020","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_6","unstructured":"World Health Organization (2016). Global Report on Diabetes, World Health Organization. Available online: https:\/\/iris.who.int\/handle\/10665\/204871."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Skoglund, G., Nilsson, B.B., Olsen, C.F., Bergland, A., and Hilde, G. (2022). Facilitators and barriers for lifestyle change in people with prediabetes: A meta-synthesis of qualitative studies. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-12885-8"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e41933","DOI":"10.2196\/41933","article-title":"Challenges of Type 2 Diabetes Mellitus Management From the Perspective of Patients: Conventional Content Analysis","volume":"11","author":"Nikpour","year":"2022","journal-title":"Interact. J. Med. Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Mahrouseh, N., Lovas, S., Njuguna, D.W., Nellamkuzhi, N.J., Soares Andrade, C.A., Sackey, W.E., Irawan, A.S., and Varga, O. (2022). How the European Union legislations are tackling the burden of diabetes mellitus: A legal surveillance study. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1002265"},{"key":"ref_10","unstructured":"European Parliament (2024, June 12). European Parliament resolution of 23 November 2022 on Prevention, Management and Better Care of Diabetes in the EU on the Occasion of World Diabetes Day. Available online: https:\/\/www.europarl.europa.eu\/doceo\/document\/TA-9-2022-0409_EN.html."},{"key":"ref_11","unstructured":"International Diabetes Federation European Region (2024, June 12). Diabetes\u2014The Policy Puzzle: Towards Benchmarking in the EU 25. Available online: https:\/\/health.ec.europa.eu\/system\/files\/2016-11\/policy_puzzle_benchmarking_eu25_0.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Manios, Y., Lambrinou, C.P., Mavrogianni, C., Cardon, G., Lindstr\u00f6m, J., Iotova, V., Tankova, T., Rurik, I., Stappen, V.V., and Kivel\u00e4, J. (2020). Lifestyle Changes Observed among Adults Participating in a Family- and Community-Based Intervention for Diabetes Prevention in Europe: The 1st Year Results of the Feel4Diabetes-Study. Nutrients, 12.","DOI":"10.3390\/nu12071949"},{"key":"ref_13","unstructured":"OECD (2022). Healthy Eating and Active Lifestyles: Best Practices in Public Health, OECD."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tuomilehto, J., Uusitupa, M., Gregg, E.W., and Lindstr\u00f6m, J. (2023). Type 2 Diabetes Prevention Programs\u2014From Proof-of-Concept Trials to National Intervention and Beyond. J. Clin. Med., 12.","DOI":"10.3390\/jcm12051876"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1056\/NEJM200105033441801","article-title":"Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance","volume":"344","author":"Tuomilehto","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_16","unstructured":"NHLBI (2024, June 12). Study Quality Assessment Tools, Available online: https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s12020-018-1542-3","article-title":"A randomized general population study of the effects of repeated health checks on incident diabetes","volume":"60","author":"Skaaby","year":"2018","journal-title":"Endocrine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S108","DOI":"10.1097\/01.ASN.0000070157.96264.13","article-title":"Prevention of diabetes mellitus in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study: Results from a randomized clinical trial","volume":"14","author":"Eriksson","year":"2003","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1016\/S0140-6736(06)69701-8","article-title":"Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: Follow-up of the Finnish Diabetes Prevention Study","volume":"368","author":"Peltonen","year":"2006","journal-title":"Lancet Lond. Engl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s00125-012-2752-5","article-title":"Improved lifestyle and decreased diabetes risk over 13 years: Long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS)","volume":"56","author":"Peltonen","year":"2013","journal-title":"Diabetologia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2337\/dc10-1288","article-title":"Reduction in the incidence of type 2 diabetes with the Mediterranean diet: Results of the PREDIMED-Reus nutrition intervention randomized trial","volume":"34","author":"Babio","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s00125-012-2492-6","article-title":"Delaying progression to type 2 diabetes among high-risk Spanish individuals is feasible in real-life primary healthcare settings using intensive lifestyle intervention","volume":"55","author":"Costa","year":"2012","journal-title":"Diabetologia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/M13-1725","article-title":"Prevention of diabetes with Mediterranean diets: A subgroup analysis of a randomized trial","volume":"160","author":"Estruch","year":"2014","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.diabres.2018.01.006","article-title":"Effective translation of a type-2 diabetes primary prevention programme into routine primary care: The PreDE cluster randomised clinical trial","volume":"139","author":"Sanchez","year":"2018","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"de la Cruz-Ares, S., Guti\u00e9rrez-Mariscal, F.M., Alcal\u00e1-D\u00edaz, J.F., Quintana-Navarro, G.M., Podadera-Herreros, A., Cardelo, M.P., Torres-Pe\u00f1a, J.D., Arenas-de Larriva, A.P., P\u00e9rez-Mart\u00ednez, P., and Delgado-Lista, J. (2021). Quality and Quantity of Protein Intake Influence Incidence of Type 2 Diabetes Mellitus in Coronary Heart Disease Patients: From the CORDIOPREV Study. Nutrients, 13.","DOI":"10.3390\/nu13041217"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Penn, L., White, M., Oldroyd, J., Walker, M., Alberti, K.G.M., and Mathers, J.C. (2009). Prevention of type 2 diabetes in adults with impaired glucose tolerance: The European Diabetes Prevention RCT in Newcastle upon Tyne, UK. BMC Public Health, 9.","DOI":"10.1186\/1471-2458-9-342"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/S2213-8587(13)70204-3","article-title":"Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: A family-cluster randomised controlled trial","volume":"2","author":"Bhopal","year":"2014","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ypmed.2015.12.012","article-title":"A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: The Let\u2019s Prevent Diabetes cluster randomised controlled trial","volume":"84","author":"Davies","year":"2016","journal-title":"Prev. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1007\/s00125-019-05061-y","article-title":"A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent type 2 diabetes in India and the UK: A randomised controlled trial","volume":"63","author":"Nanditha","year":"2020","journal-title":"Diabetologia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1001\/jamainternmed.2020.5938","article-title":"Lifestyle Intervention with or Without Lay Volunteers to Prevent Type 2 Diabetes in People with Impaired Fasting Glucose and\/or Nondiabetic Hyperglycemia: A Randomized Clinical Trial","volume":"181","author":"Sampson","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1038\/ejcn.2011.74","article-title":"Predictors of lifestyle intervention outcome and dropout: The SLIM study","volume":"65","author":"Roumen","year":"2011","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e223","DOI":"10.1111\/j.1464-5491.2012.03648.x","article-title":"A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care: 2.5-year results of a randomized controlled trial","volume":"29","author":"Vermunt","year":"2012","journal-title":"Diabet. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"276","DOI":"10.11613\/BM.2012.031","article-title":"Interrater reliability: The kappa statistic","volume":"22","author":"McHugh","year":"2012","journal-title":"Biochem. Medica"},{"key":"ref_34","unstructured":"World Health Organization (1999). Department of Noncommunicable Disease Surveillance. Definition, Diagnosis, and Classification of Diabetes Mellitus. Part 1: Diagnosis and Classification of Diabetes Mellitus, WHO. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/66040\/WHO_NCD_NCS_99.2.pdf?sequence=1."},{"key":"ref_35","unstructured":"World Health Organization (2011). Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus, WHO. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/70523\/WHO_NMH_CHP_CPM_11.1_eng.pdf."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Gumber, A., and Gumber, L. (2017). Improving prevention, monitoring and management of diabetes among ethnic minorities: Contextualizing the six G\u2019s approach. BMC Res. Notes, 10.","DOI":"10.1186\/s13104-017-3104-9"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1093\/ije\/dyn176","article-title":"The promise and challenges of population strategies of prevention","volume":"37","author":"Michels","year":"2008","journal-title":"Int. J. Epidemiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ssmph.2016.11.002","article-title":"Efficiency or equity? Simulating the impact of high-risk and population intervention strategies for the prevention of disease","volume":"3","author":"Platt","year":"2017","journal-title":"SSM-Popul. Health"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Goveia, P., Ca\u00f1on-Monta\u00f1ez, W., Santos, D.P., Lopes, G.W., Ma, R.C.W., Duncan, B.B., Ziegelman, P.K., and Schmidt, M.I. (2018). Lifestyle Intervention for the Prevention of Diabetes in Women With Previous Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Front. Endocrinol., 9.","DOI":"10.3389\/fendo.2018.00583"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1056\/NEJMoa012512","article-title":"Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin","volume":"346","author":"Knowler","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Karamanakos, G., Costa-Pinel, B., Gilis-Januszewska, A., Velickiene, D., Barrio-Torrell, F., Cos-Claramunt, X., Mestre-Miravet, S., Piwo\u0144ska-Solska, B., Hubalewska-Dydejczyk, A., and Tuomilehto, J. (2019). The effectiveness of a community-based, type 2 diabetes prevention programme on health-related quality of life. The DE-PLAN study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0221467"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s13643-021-01619-3","article-title":"Community-based educational interventions for prevention of type II diabetes: A global systematic review and meta-analysis","volume":"10","author":"Shirvani","year":"2021","journal-title":"Syst. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s43058-022-00258-6","article-title":"Implementation of a diabetes prevention program within two community sites: A qualitative assessment","volume":"3","author":"Dineen","year":"2022","journal-title":"Implement. Sci. Commun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/s13012-015-0354-6","article-title":"A systematic review of real-world diabetes prevention programs: Learnings from the last 15 years","volume":"10","author":"Aziz","year":"2015","journal-title":"Implement. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e003203","DOI":"10.1136\/bmjdrc-2022-003203","article-title":"Knowledge, attitude, and practice toward pre-diabetes among the public, patients with pre-diabetes and healthcare professionals: A systematic review","volume":"11","author":"Teoh","year":"2023","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e13571","DOI":"10.1111\/obr.13571","article-title":"A systematic review of patient barriers and facilitators for implementing lifestyle interventions targeting weight loss in primary care","volume":"24","author":"Jansen","year":"2023","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Aziz, Z., Riddell, M.A., Absetz, P., Brand, M., Oldenburg, B., and Australasian Peers for Progress Diabetes Project Investigators (2018). Peer support to improve diabetes care: An implementation evaluation of the Australasian Peers for Progress Diabetes Program. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5148-8"},{"key":"ref_48","first-page":"511","article-title":"The burden of type 2 diabetes: Strategies to prevent or delay onset","volume":"3","author":"Iqbal","year":"2007","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"(2024, June 12). Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes\u20142021|Diabetes Care|American Diabetes Association. Available online: https:\/\/diabetesjournals.org\/care\/article\/44\/Supplement_1\/S34\/30895\/3-Prevention-or-Delay-of-Type-2-Diabetes-Standards.","DOI":"10.2337\/dc21-S003"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1177\/0145721717722968","article-title":"2017 National Standards for Diabetes Self-Management Education and Support","volume":"43","author":"Beck","year":"2017","journal-title":"Diabetes Educ."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.2337\/dc23-S002","article-title":"2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes\u20142023","volume":"46","author":"ElSayed","year":"2022","journal-title":"Diabetes Care"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/6\/1053\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:55:06Z","timestamp":1760028906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/6\/1053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":51,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["nu17061053"],"URL":"https:\/\/doi.org\/10.3390\/nu17061053","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]}}}