title: Evidence based review of type 2 diabetes prevention and management in low and middle income countries.
abstract: OBJECTIVE
  To identify the newest approaches to type 2 diabetes (T2DM) prevention and control in the developing world context.
  
  
  METHODS
  We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries, as defined by the World Bank. We searched PubMed using Medical Subject Headings terms. Studies needed to satisfy four criteria: (1) Must be experimental; (2) Must include patients with T2DM or focusing on prevention of T2DM; (3) Must have a lifestyle intervention component; (4) Must be written in English; and (5) Must have measurable outcomes related to diabetes.
  
  
  RESULTS
  A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014. India contributed the largest number of trials (11/66). Of the total 66 studies reviewed, all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes. The overwhelming majority of studies reported on diabetes management (56/66), and among these more than half were structured lifestyle education programs. The evidence suggests that lifestyle education led by allied health professionals (nurses, pharmacists) were as effective as those led by physicians or a team of clinicians. The remaining diabetes management interventions focused on diet or exercise, but the evidence to recommend one approach over another was weak.
  
  
  CONCLUSIONS
  Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise.
authors.affiliation: Aimee Afable, Nidhi Shree Karingula, Department of Community Health Sciences, SUNY Downstate School of Public Health, New York, NY 11203, United States.
authors.forename: Aimee
authors.initials: A
authors.lastname: Afable
authors.affiliation: Aimee Afable, Nidhi Shree Karingula, Department of Community Health Sciences, SUNY Downstate School of Public Health, New York, NY 11203, United States.
authors.forename: Nidhi Shree
authors.initials: NS
authors.lastname: Karingula
keywords: Diabetes prevention and control; Intervention research; Low-income countries; Middle-income countries; Systematic reviews