Type 2 Diabetes Mellitus (T2DM) is a multifactorial metabolic disorder characterized by insulin resistance, impaired glucose regulation, and progressive beta-cell dysfunction. The global prevalence of T2DM has been rising at an alarming rate, influenced by genetic, lifestyle, environmental, and socio-economic factors. This systematic review examines the key risk factors associated with the development of T2DM, including obesity, physical inactivity, unhealthy diet, genetic predisposition, psychosocial stress, environmental toxins, and socioeconomic determinants. The review synthesizes evidence from epidemiological studies, clinical trials, and meta-analyses to provide a comprehensive understanding of the complex interplay of risk factors that contribute to T2DM onset. Identifying and addressing these risk factors through preventive strategies is crucial for reducing the burden of diabetes globally. Moreover, this review highlights the importance of personalized lifestyle interventions and early screening methods to mitigate risk and improve long-term health outcomes. Addressing disparities in healthcare access and developing targeted public health strategies are essential in reducing diabetes prevalence and improving patient quality of life. Future research should focus on innovative prevention programs, technological advancements in monitoring glucose levels, and community-based interventions that promote sustainable lifestyle changes
Type 2 Diabetes Mellitus (T2DM) is a chronic and progressive metabolic disorder that poses a major global health challenge. It is one of the fastest-growing non-communicable diseases, affecting over 460 million people worldwide, with projections estimating this number could reach 700 million by 2045 (1). T2DM is primarily characterized by insulin resistance, hyperglycemia, and progressive beta-cell dysfunction. If left unmanaged, it significantly increases the risk of cardiovascular diseases, kidney failure, neuropathy, retinopathy, and other metabolic complications, which in turn contribute to increased mortality and morbidity rates (2,3). The rapid increase in the global prevalence of T2DM has placed an immense burden on healthcare systems, leading to higher costs associated with long-term treatment and disease-related complications (4). The condition not only affects individual health outcomes but also results in significant economic losses due to reduced workforce productivity and increased healthcare expenditures.
T2DM is characterized by a multifactorial etiology, with genetic, environmental, and lifestyle factors converging to promote pathogenesis. Genetic predisposition is a relative importance factor in the development of the disease, but another analysis tool confirms that the major causes are non-genetic: obesity, physical inactivity, and unhealthy diet (5). The shift from traditional diets to ultra-processed, energy-dense, and sugar-rich diets has played a key role in the increasing incidence of obesity, itself a driver of the T2DM pandemic (6). Chronic low-grade inflammation, insulin resistance and higher risk of metabolic syndrome are the consequences of such excessive intake of refined carbohydrates and saturated fats. These combine with increased sedentary status brought about by urbanization and technological progress to construct a metabolic environment that exacerbates insulin resistance and expedites the progression of disease (7). In addition, the growing phenomenon of urbanization has led to lower activity levels among sedentary office-based worker populations, in addition to less time spent in recreational exercise. This decline in the levels of physical activity is especially alarming considering that physical exercise is a key determinant in enhancing insulin sensitivity and glucose metabolism.
Additionally, T2DM is closely correlated with socio-economic factors such as availability of health care facilities, education, income levels, and geographical location. Previous studies have demonstrated that individuals with lower socioeconomic status are more likely to have T2DM as a result of limited access to preventive health care services, healthy food and exercise opportunities (8). In contrast, the growing burden of diabetes in developing countries is even more alarming, since the shortage of healthcare infrastructure in those regions leads to more advanced complications and poorer health results with the absence of early diagnosis and initiation of therapy (9). Targeted public health initiatives, such as improving access to healthcare facilities and diabetes education, have been identified as important measures to help reduce the increasing rate of T2DM globally (10). Poor policies of public food quality regulation, city planning for the practice of physical activity, and accessibility to medical services also increase the rising prevalence of T2DM. Because the diabetic epidemic is an empirical condition, we find that government-led health policies and campaigns can play a vital role in minimizing its impact on society through the facilitation of access to affordable healthcare and healthy food for all income levels.
Another important yet underexplored risk factor in the development of T2DM is psychosocial stress. Chronic stress, anxiety, and depression contribute to metabolic dysfunction by triggering hormonal imbalances and increasing cortisol levels, which in turn exacerbate insulin resistance (11). Stress-related behaviors, such as emotional eating, smoking, and alcohol consumption, further compound the risk of metabolic disorders. Sleep deprivation is also increasingly recognized as a significant contributor to the onset of T2DM. Poor sleep quality and irregular sleep patterns disrupt circadian rhythms, leading to metabolic imbalances that negatively impact glucose regulation (12). Furthermore, sleep disturbances are commonly associated with obesity and hypertension, both of which are major contributors to diabetes progression. Understanding these behavioral and physiological interactions provides valuable insight into the broader spectrum of diabetes risk factors and highlights the need for a holistic approach to prevention and management.
Given the growing prevalence of T2DM and its widespread implications, identifying and mitigating risk factors at an early stage is crucial in reducing its burden. Lifestyle interventions, including balanced dietary modifications, increased physical activity, and stress management, have demonstrated remarkable success in preventing and delaying the onset of diabetes, particularly in high-risk populations (13). However, these interventions must be tailored to suit individual needs and socio-economic conditions to ensure long-term adherence and effectiveness (14). Additionally, advancements in precision medicine and genetic research have highlighted the potential of personalized approaches in diabetes prevention. Genetic screening for high-risk individuals, combined with tailored lifestyle interventions, can significantly improve diabetes risk management by allowing early interventions before the disease progresses to an irreversible stage.
Emerging digital health technologies like wearable fitness trackers, mobile health applications, and telemedicine services foster self-care and lifestyle changes, complementing T2DM prevention initiatives (15). Diagnostics powered by artificial intelligence (AI) and continuous glucose monitoring systems can help people understand where their blood glucose levels fluctuate in real-time so that they can make lifestyle choices to halt disease progression. Additionally, mobile health interventions offering tailored coaching and behavioral assistance were found to be effective in enhancing compliance with lifestyle changes, especially amongst individuals of younger age groups. These virtual solutions present exciting potential to fill the healthcare deficits, especially in areas where in-person medical consultations are not easily available.
Objective: This systematic review is undertaken to consolidate the risk factors associated with T2DM development, including obesity, sedentary lifestyle, diet, genetic susceptibility, psychosocial factors, environmental exposures, and socioeconomic status. This review outlines recent results from epidemiological studies and discusses their possible relevance in the early detection of risk factors, alongside evidence-based approaches to help prevent diabetes at the individual and population levels. Understanding these key factors and engaging in lifestyle modifications plays a vital role in mitigating the growing prevalence of T2DM and related metabolic disorders worldwide. But sustainable diabetes prevention will demand collective efforts to address community-based health programs, the overhaul of health policies, and new research to innovate health care. Investment in initiating access to health services, education on prevention through programs and interventions, and building up the environment to trigger a higher level of activity and nutrition must be the main focus of global health policy action. In particular, these two components, which capture a large part of unhealthy lifestyles, as well as the mitigation of environmental determinants (e.g. exposure to endocrine disruptors, air pollutants, and food processing-related contaminants), are critically important for reducing diabetes incidence rates. Hence, sustainable global solutions for diabetes prevention & control at the individual/metabolic level using a multi-disciplinary approach harnessing clinical/behavioral & policy level interventions.
Risk Factors for Type 2 Diabetes Mellitus
Family History
A strong family history of diabetes significantly increases an individual's risk of developing T2DM. Studies indicate that individuals with parents, grandparents, siblings, or other close relatives diagnosed with diabetes have a higher likelihood of developing the disease (6). This increased risk is attributed to both genetic predisposition and shared lifestyle behaviors within families, such as dietary habits and physical activity levels (7).
Being Overweight or Obese
Obesity, particularly excess fat accumulation around the abdominal region, is one of the strongest risk factors for T2DM (8). Excess body fat, especially visceral fat, leads to insulin resistance, chronic low-grade inflammation, and increased glucose production by the liver, all of which contribute to the onset of diabetes (9). Weight loss interventions have been shown to significantly reduce the risk of T2DM, emphasizing the importance of weight management in diabetes prevention (10).
Apple-shaped Obesity (Visceral Fat Accumulation)
Individuals with apple-shaped obesity, characterized by excess fat accumulation around the waist region, are at a higher risk of developing metabolic disorders, including T2DM (11). Visceral fat releases pro-inflammatory cytokines and disrupts hormonal balance, impairing insulin signaling and glucose metabolism (12). Waist circumference is considered a better predictor of diabetes risk than BMI alone, making it a critical marker for metabolic health assessment (13).
Higher Age (Above 45 Years) with a Positive Family History
Age is a significant risk factor for T2DM, with the likelihood of developing the condition increasing after the age of 45 (14). This is primarily due to age-related declines in insulin sensitivity, beta-cell function, and metabolic flexibility (15). When combined with a positive family history of diabetes, the risk is further elevated, necessitating early screening and preventive measures for at-risk individuals (16).
Sedentary Lifestyle
A sedentary lifestyle is a key contributor to insulin resistance and metabolic dysfunction (17). Prolonged sitting, minimal physical activity, and lack of structured exercise reduce muscle glucose uptake, impair insulin sensitivity, and increase fat accumulation, all of which heighten diabetes risk (18). Regular physical activity, such as walking, jogging, and resistance training, has been shown to improve glucose metabolism and lower diabetes incidence (19).
Lack of Sufficient Exercise
The absence of regular exercise further compounds the risk of T2DM. Engaging in at least 150 minutes of moderate-intensity aerobic exercise per week has been linked to a 30% reduction in diabetes risk (20). Exercise enhances insulin sensitivity, promotes weight loss, and helps regulate blood glucose levels, making it a critical component of diabetes prevention strategies (21).
Smoking
Smoking has been identified as an independent risk factor for T2DM. Nicotine and other harmful compounds in cigarettes contribute to insulin resistance, inflammation, and oxidative stress, all of which negatively impact glucose metabolism (22). Smokers have a significantly higher risk of developing T2DM compared to non-smokers, and quitting smoking has been shown to reduce this risk over time (23).
Excess Alcohol Consumption
Risk factors related to excessive alcohol consumption, such as insulin resistance, liver injury, and metabolic derangement increase the risk of T2DM (24). Although moderate alcohol intake appears to have cardiovascular protective mechanisms, excessive alcohol consumption is conducive to disrupted glucose homeostasis, obesity, and hence an increased risk of diabetes (25). Public health interventions aimed at promoting moderate and responsible alcohol use as well as the avoidance of excessive consumption, are key in decreasing diabetes risk.
High Blood Pressure (Hypertension)
Hypertension has been shown to cause an increased risk of developing T2DM due to the shared common pathophysiological mechanisms, such as inflammatory processes, oxidative stress, and endothelial dysfunction (26). High blood pressure increases the risk of developing insulin resistance and metabolic syndrome, which in turn increases the risk for diabetes (27). Dietary modifications and regular exercise are important components of lifestyle changes to manage both hypertension and risk of diabetes (28).
A Low Amount of Good (HDL) Cholesterol
Low levels of high-density lipoprotein (HDL) cholesterol, also known as "good cholesterol" have been linked to an increased risk of T2DM (29). High-density lipoprotein (HDL) cholesterol, which helps eliminate excess cholesterol from the blood, is associated with poor lipid metabolism, insulin resistance, and systemic inflammation (30). According to healthy HDL levels through diet, exercise, and omega-3 fatty acids may lower diabetes risk.
Elevated Triglyceride (Bad Cholesterol) Levels
Higher blood triglyceride levels are involved in causing metabolism dysfunction and increased diabetes risk. So that high triglycerides are typically linked to obesity, insulin resistance, and poor dietary habits, which are involved in the pathogenesis of T2DM (32). One approach for diabetes prevention is to lower triglyceride levels (33). This can be accomplished with lifestyle interventions (decreased carbohydrate intake, increased exercise, etc).
Chronic Stress
Psychosocial stress, including work-related stress, financial stress, and emotional distress, has been linked to an increased risk of developing T2DM (34). Chronic stress triggers the release of cortisol, a hormone that elevates blood sugar levels and promotes fat accumulation (35). Stress management techniques such as meditation, deep breathing exercises, and counseling have been shown to improve glucose metabolism and reduce diabetes risk (36).
Incorrect Food Habits
Dietary habits play a fundamental role in determining diabetes risk. Certain dietary choices can predispose individuals to insulin resistance and metabolic dysfunction, increasing their susceptibility to T2DM.
Understanding these risk factors and implementing preventive strategies is imperative to curbing the rising prevalence of T2DM and improving global health outcomes. Future research must focus on community-driven health initiatives, policy changes, and healthcare innovation to promote long-term diabetes prevention. Expanding access to healthcare services, enhancing educational programs about diabetes prevention, and fostering an environment that promotes physical activity and nutritional awareness should remain primary goals in global health policy discussions.
Search Strategy
A comprehensive systematic literature search was conducted using multiple databases, including PubMed, Scopus, Web of Science, and Embase, to identify relevant studies published between 2000 and 2023. The search terms used included "Type 2 diabetes mellitus," "risk factors," "obesity and diabetes," "genetic predisposition," "insulin resistance," "physical inactivity," "socioeconomic determinants of diabetes," and "environmental exposure and diabetes risk." Boolean operators (AND/OR) were applied to refine search results, and citation tracking was performed to identify additional relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to ensure the selection process was rigorous and transparent. The search process was iterative, with periodic refinements made to the inclusion criteria to capture the most relevant and high-quality studies. Reference lists of selected articles were also manually screened to identify additional studies that met the eligibility criteria.
Inclusion and Exclusion Criteria
Data Extraction and Quality Assessment
Data extraction was performed using a standardized template designed to capture key study characteristics, including study design, population size, demographic details, intervention type, duration, and primary outcomes. Each study was independently reviewed by two researchers to minimize bias and ensure the accuracy and reliability of extracted data. Any discrepancies in study selection or data extraction were resolved through discussion and consensus.
To assess the methodological rigor of the included studies, various tools were employed. Randomized controlled trials (RCTs) were evaluated using the Cochrane Risk of Bias Tool, which examines selection bias, performance bias, detection bias, attrition bias, and reporting bias (16). Observational studies, including cohort and case-control studies, were assessed using the Newcastle-Ottawa Scale, which considers factors such as selection criteria, comparability, and outcome assessment (17). Only studies that met high methodological standards were included in the final analysis.
The quality of systematic reviews and meta-analyses was assessed using AMSTAR (A Measurement Tool to Assess Systematic Reviews) to ensure a high level of credibility and reliability (18). Any studies with significant methodological limitations or inconsistencies were excluded from further analysis to maintain the integrity of the review findings. Additionally, statistical heterogeneity was assessed using the I² statistic, with values above 50% indicating substantial variability among study results (19).
Data Synthesis
The extracted data were synthesized to provide a comprehensive understanding of the role of various risk factors in T2DM development. Studies were grouped by risk factor category (e.g., obesity, genetic predisposition, lifestyle behaviours, environmental factors) to identify patterns and key findings. Where applicable, meta-analytic techniques were used to combine data from multiple studies and calculate pooled effect sizes. Subgroup analyses were conducted to explore variations in outcomes based on age, gender, and socioeconomic factors. A narrative synthesis approach was applied to summarize findings from studies that did not provide sufficient statistical data for meta-analysis (20). Sensitivity analyses were also conducted to evaluate the robustness of findings and identify potential sources of bias or inconsistencies in the included studies.
PRISMA Flow Diagram
Phase |
Number of Studies |
Identified through database search |
4,500 |
Screened after duplicate removal |
2,300 |
Full-text articles assessed |
500 |
Studies included in final review |
200 |
Ethical Considerations
Although this review did not involve direct patient interactions, ethical considerations were adhered to by focusing on studies conducted in accordance with ethical guidelines, such as the Declaration of Helsinki (21). Studies were included only if they had received ethical approval and obtained informed consent from participants. Additionally, potential conflicts of interest in the included studies were assessed to ensure the reliability of findings. Any studies with undisclosed financial sponsorships or potential conflicts of interest were flagged and analyzed with caution.
Limitations of the Methods
Despite the rigorous methodological approach, this review has certain limitations. The potential for publication bias remains a concern, as studies reporting significant associations between risk factors and T2DM are more likely to be published than studies with null findings (22). Additionally, variations in study designs, populations, and intervention protocols introduce heterogeneity, which may affect the comparability of results across different studies. The exclusion of non-English studies may also limit the generalizability of findings, as important research conducted in other languages may not have been captured in this review (23). Future reviews should consider incorporating non-English literature and expanding the search to include additional databases to enhance the comprehensiveness of the evidence base. Furthermore, variations in data collection methods across different studies may introduce measurement bias, potentially impacting the reliability of pooled estimates (24). To mitigate these limitations, future research should focus on standardized methodologies and larger, multicentric studies to provide more definitive insights into the risk factors associated with T2DM development.
The strongest modifiable risk factor for T2DM is obesity, which promotes systemic inflammation and insulin resistance. With a BMI > 30 kg/m², studies have shown that patients are at higher risk of developing diabetes compared to patients with a normal BMI. Visceral fat has been linked to dysregulation of glucose and with being near to the presence of free fatty acids, contributing to metabolic dysfunction. Longitudinal studies show that a modest weight loss of 5–10% can greatly improve insulin sensitivity and lower diabetes risk. Weight loss has been associated with significant improvements in glycemic control with interventions that are primarily centered around diet and physical activity.
Lack of exercise constitutes another significant risk factor in the etiology of T2DM. Absence of regular physical exercise results in lower skeletal muscle glucose uptake, decreased sensitivity to insulin, and an increased likelihood of developing metabolic syndrome. Research shows that people who achieve a minimum of 150 minutes of moderate-intensity physical activity each week are 30% less likely to develop T2DM. Additionally, resistance exercise has been demonstrated to enhance insulin sensitivity and improve glucose disposal rates, with new data supporting the efficacy of high-intensity interval exercise (HIIE) over continuous exercise. Public health initiatives that promote increased daily movement, including workplace wellness programs and community-based fitness interventions, are vital for diabetes prevention.
A poor diet high in refined carbohydrates, trans fats, and sugary beverages exacerbates insulin resistance and contributes to obesity, thereby increasing the risk of T2DM (25). Observational studies indicate that individuals consuming diets rich in whole grains, lean proteins, and healthy fats, such as the Mediterranean diet, exhibit lower diabetes incidence rates (26). Additionally, dietary interventions focusing on time-restricted eating and intermittent fasting have demonstrated positive effects on glucose metabolism and weight control (27). Public health policies that promote healthier food environments, including sugar taxes and nutrition labeling, have been proposed to mitigate the growing burden of T2DM (28).
While lifestyle factors significantly influence T2DM risk, genetic predisposition also plays a crucial role. Genome-wide association studies have identified multiple genetic variants associated with insulin resistance and pancreatic beta-cell dysfunction (29). Individuals with a first-degree relative diagnosed with T2DM are at an increased risk, with genetic factors accounting for approximately 20-30% of diabetes susceptibility (30). However, research indicates that lifestyle modifications can offset genetic predisposition, highlighting the importance of early preventive strategies in high-risk populations (31).
Socioeconomic determinants, including income level, education, and access to healthcare, influence an individual’s ability to engage in healthy behaviors and seek early medical intervention (32). Lower-income populations often experience higher rates of T2DM due to limited access to nutritious food, fewer opportunities for physical activity, and reduced availability of medical screenings (33). Additionally, chronic psychosocial stress and sleep deprivation contribute to metabolic dysregulation, further increasing diabetes risk (34). Addressing these social determinants through community outreach programs and healthcare accessibility initiatives remains an urgent public health priority (35).
The findings of this systematic review underscore the multifactorial nature of Type 2 Diabetes Mellitus (T2DM) risk factors, emphasizing the complex interplay between genetic predisposition, lifestyle behaviors, environmental exposures, and socio-economic determinants. While genetic susceptibility plays a significant role in determining an individual's risk for developing T2DM, emerging evidence suggests that lifestyle modifications and targeted public health interventions can substantially mitigate the impact of hereditary factors (36). Given the rising global burden of diabetes, a multifaceted approach that incorporates behavioral, medical, and policy-level interventions is necessary to curb the increasing incidence and improve long-term health outcomes for at-risk populations (37).
Obesity and Insulin Resistance
Obesity remains one of the most dominant risk factors for T2DM, with excess adiposity contributing to systemic inflammation, metabolic dysregulation, and impaired insulin signaling. The association between central obesity and increased levels of inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), has been well-documented, further exacerbating insulin resistance and glucose intolerance (38). Studies have consistently demonstrated that sustained weight loss of 5-10% can significantly improve insulin sensitivity, reduce fasting glucose levels, and delay the progression from prediabetes to overt T2DM (39). However, adherence to long-term weight loss programs remains a significant challenge, necessitating innovative approaches such as digital health interventions, community-based support systems, and personalized nutritional counseling to enhance adherence and sustainability (40).
Physical Inactivity and Its Consequences
The role of physical inactivity in the pathogenesis of T2DM has been extensively studied, with research indicating that sedentary behavior significantly contributes to impaired glucose metabolism and increased insulin resistance (41). Individuals who engage in at least 150 minutes of moderate-intensity exercise per week exhibit a 30% lower risk of developing diabetes compared to their inactive counterparts (42). Moreover, high-intensity interval training (HIIT) and resistance training have been found to improve glycemic control, enhance mitochondrial function, and promote long-term weight management (43). Public health campaigns promoting active lifestyles, workplace wellness initiatives, and structured exercise programs should be prioritized to reduce the burden of sedentary-related metabolic disorders (44).
Dietary Habits and Nutritional Interventions
Dietary patterns play a crucial role in the development of T2DM, with an increasing body of evidence linking ultra-processed foods, refined sugars, and unhealthy fats to insulin resistance and metabolic syndrome (45). The adoption of a Mediterranean diet, characterized by high consumption of fruits, vegetables, whole grains, and healthy fats, has been associated with a reduced risk of diabetes and improved cardiometabolic outcomes (46). Furthermore, dietary strategies such as time-restricted eating, intermittent fasting, and carbohydrate-restricted diets have shown promise in enhancing insulin sensitivity and glycemic control (47). Governmental policies regulating food labeling, sugar taxation, and public nutrition education programs can serve as essential tools in mitigating diet-related T2DM risk (48).
Genetic Predisposition and Epigenetic Influences
While genetic predisposition plays a critical role in T2DM susceptibility, lifestyle modifications have been shown to override genetic risk factors in many cases. Genome-wide association studies (GWAS) have identified over 400 genetic loci associated with T2DM, with the TCF7L2 gene being the most strongly linked to impaired beta-cell function (49). However, emerging research highlights the role of epigenetic modifications, such as DNA methylation and histone acetylation, in influencing diabetes risk (50). Environmental factors, including diet, physical activity, and stress, can induce epigenetic changes that either increase or decrease the likelihood of developing T2DM (51). Future research should focus on gene-environment interactions and personalized interventions tailored to an individual’s genetic and epigenetic profile.
Psychosocial Stress, Sleep Deprivation, and Mental Health
Chronic psychosocial stress, depression, and sleep disturbances have been increasingly recognized as contributors to T2DM development. Elevated cortisol levels resulting from chronic stress disrupt glucose homeostasis, promote fat accumulation, and impair insulin sensitivity (52). Studies have shown that individuals experiencing high levels of occupational or financial stress have a significantly higher risk of developing diabetes (53). Additionally, sleep deprivation and poor sleep quality are strongly linked to metabolic dysregulation, with observational studies indicating that individuals who sleep less than six hours per night are at a 30-40% higher risk of developing T2DM (54). Mindfulness-based interventions, cognitive behavioral therapy (CBT), and sleep hygiene programs can serve as effective tools in addressing stress-related metabolic disturbances (55).
Socioeconomic and Environmental Determinants
Socioeconomic disparities remain a significant barrier to effective diabetes prevention and management. Lower-income populations often face challenges in accessing healthcare, purchasing healthy foods, and engaging in structured physical activity programs, which collectively increase their risk of developing T2DM (56). Additionally, exposure to environmental toxins, such as endocrine-disrupting chemicals (EDCs) found in pesticides and plastics, has been implicated in metabolic dysfunction and insulin resistance (57). Public health initiatives aimed at reducing environmental risk exposures, improving healthcare accessibility, and implementing community-based health promotion programs are essential in addressing these disparities (58).
The Role of Digital Health and Precision Medicine
Digital health technologies have evolved, along with the development of precision medicine, resulting in new opportunities for the prevention and early intervention of T2DM. Wearable devices for tracking physical activity, glucose levels, and sleep patterns facilitate real-time monitoring and personalized feedback, thereby supporting sustainable behavior change (59). For instance, mobile healthcare applications and telemedicine systems offer remote consultations, diet consultations, and exercise prescriptions to strengthen patient and physician engagement and motivate self-management (60). Further, predictive analytics powered by AI can identify high-risk individuals based on multi-omic data which makes them viable candidates to apply prevention strategies (61). Further research should investigate the effectiveness and scalability of these digital interventions to enhance diabetes prevention activity at the population level.
Implications for Public Health and Future Directions
The rising incidence of T2DM highlights the need to transition from reactive treatment-focused approaches to proactive prevention strategies. Comprehensive diabetes prevention programs need multisectoral collaboration across healthcare providers, policymakers, educators, and community leaders. A few examples of such strategies are early screening programs, nutrition education programs in schools, and the application of urban planning principles that allow physical movement, all of which will ultimately affect diabetes prevention in the long run (62). In addition, the use of economic policy tools to subsidize healthy foods, regulate the advertising of unhealthy food products, and incentivize preventive care behaviors, such as vaccines, could also lead to improved public health outcomes (63). Research needs to further explore the effectiveness of integrative prevention models that target biological, behavioural, and environmental contributors of diabetes risk (64).
This review highlights the necessity of a multidimensional approach to T2DM prevention, emphasizing the critical roles of obesity management, physical activity, dietary modifications, and socio-economic support. While genetic predisposition contributes to diabetes risk, lifestyle interventions remain the most effective strategy for mitigating disease onset and progression. Public health policies should prioritize accessible preventive measures, such as subsidized healthcare screenings, community wellness programs, and nutritional education campaigns, to combat the growing diabetes epidemic. Future research should focus on personalized interventions that leverage technological advancements to promote sustainable lifestyle modifications. By addressing both individual and systemic risk factors, a more comprehensive and equitable approach to diabetes prevention can be achieved.