Multilevel Interventions for Diabetes in India: A Systematic Literature Review

Abstract

Background: With over 101 million diabetes mellitus (DM) and 136 million adults with prediabetes in India, DM poses a major public health challenge. If current trends hold, that figure is expected to climb to 134 million by 2045. The rising incidence is linked to a complex interaction of genetic susceptibility combined with urbanization, sedentary lifestyles, and dietary shifts. Diabetes should be tackled at the individual, community, and systems levels so that we can do justice to the health of the nation.

Objective: This SLR summarizes the effectiveness of multilevel interventions for diabetes prevention and management in India, identifies implementation barriers, and highlights research and policy gaps.

Methods: A systematic search following PRISMA 2020 guidelines was performed in PubMed, Scopus, Web of Science, and Google Scholar. The literature review consists of studies published from 2014 to 2024 that included diabetes interventions at the individual, community, and system levels in India were included. Twenty one studies were included in the final analysis.

Results: Individual-Level Interventions: Lifestyle changes, mHealth approaches and stress management programs demonstrated efficacy but had challenged adherence.

Community-Based Interventions: Community Health Worker (CHW) programs increase diabetes awareness; school and workplace wellness programs decrease obesity and diabetes risk factors.

System-Level Interventions: Government-led initiatives - National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS), digital health technologies, and some AI-based interventions were successful in promoting diabetes prevention but had barriers to implementation related to accessibility and availability

Conclusion: A multilevel approach involving individual, community, and systemic interventions is necessary to manage diabetes effectively in India. Strengthening public health policies, leveraging digital health technologies, and promoting lifestyle modifications are crucial for reducing the diabetes burden. Future research should explore personalized medicine, including genetic screening and AI-driven predictive models, to enhance diabetes prevention strategies.