The effectiveness of lifestyle interventions in reducing cardiovascular risk and risk factors in people with prediabetes: A systematic review and meta-analysis.

Aim: This systematic review and meta-analysis examined the effectiveness of lifestyle interventions in reducing cardiovascular disease (CVD) risk, CVD events, and related risk factors among individuals with prediabetes.

Data synthesis: We conducted a search of the MEDLINE, Embase, PsycINFO, CENTRAL, and Scopus databases, along with ClinicalTrials.gov, for lifestyle-based randomized controlled trials (RCTs) involving individuals with prediabetes. Our focus was on interventions that lasted at least six months and were published between 1997 and April 2024. Two authors independently screened the abstracts and titles of the retrieved articles, followed by full-text reviews and data extraction from forty-two eligible studies. The primary outcomes examined were changes in CVD risk and CVD events, and the secondary outcomes were changes in CVD risk factors. We utilized random-effects meta-analysis to calculate pooled effects. Forty-two studies (n=18,615, mean age =54.9, male (45.4 %)) were included. Lifestyle interventions reduced CVD risk (standardized mean difference (SMD): -1.91; 95 % CI: -2.89, -0.93, p<0.010) among the intervention group compared to the control group. Lifestyle interventions have also been shown to reduce various CVD risk factors, including the incidence of type 2 diabetes.

Conclusion: This review demonstrates more evidence to support lifestyle interventions being an important strategy for individuals with prediabetes to reduce their risk of developing CVD and its associated risk factors. PROSPERO registration Number: CRD42023429869.