The Effectiveness of Diabetes Prevention Programs Delivered in Primary Care for Individuals With Prediabetes or at Risk of Developing Type 2 Diabetes: A Systematic Review and Meta-analysis.

Primary care is central to prevention efforts, including screening, diagnosis, and follow-up.

初级保健在预防工作中处于核心地位，包括筛查、诊断和随访。

This systematic reviewand meta-analysisaimed to evaluate the effectiveness of lifestyle interventions delivered in primary care to patients at elevated risk of developing T2DM.

本系统评价和荟萃分析旨在评估在初级保健中对有发展2型糖尿病高风险患者进行的生活方式干预的有效性。

data_sources

We searched Medline and Embase from inception to 28 March 2024.

我们从建库开始至2024年3月28日，检索了Medline和Embase数据库。

study_selection

We screened 639 records and included 14 eligible studies of lifestyle-based diabetes prevention programs.

我们筛选了639条记录，并纳入了14项符合条件的生活方式为基础的糖尿病预防计划研究。

Eligible participants had prediabetes or high diabetes risk scores, and interventions were delivered in primary care.

符合条件的参与者有糖尿病前期或高糖尿病风险评分，干预措施在初级保健中进行。

data_extraction

Outcomes included diabetes incidence, glycemic and anthropometric indicators, physical activity, and diet.

结果包括糖尿病发病率、血糖和人体测量指标、体力活动和饮食。

data_synthesis

Pooled mean differences (MD) were estimated using inverse variance methods; leave-one-out cross-validation (LOOCV) addressed heterogeneity (>50%).

使用逆方差方法估计了汇总均数差异（MD）；留一交叉验证（LOOCV）处理了异质性（>50%）。

Meta-analysisfound no significant effects on diabetes incidence(relative risk 0.82; 95% CI 0.65-1.02), and pooled MD on HbA1c (MD -0.41, 95% CI -0.94 to 0.12), fasting glucose, 2-h glucose, body weight, BMI, waist circumference (MD -1.13, 95% CI -2.40 to 0.13), or systolic and diastolic blood pressure.

荟萃分析发现对糖尿病发病率没有显著影响（相对风险0.82；95%置信区间0.65-1.02），以及HbA1c的汇总平均差异（MD -0.41，95%置信区间-0.94至0.12）、空腹血糖、2小时血糖、体重、体质指数、腰围（MD -1.13，95%置信区间-2.40至0.13）或收缩压和舒张压均无显著差异。

LOOCV identified one study driving heterogeneity in several outcomes.

留一交叉验证（LOOCV）确定了一项研究在多个结果中导致异质性。

limitations

English-only publications may reduce generalizability.

仅使用英语发表的出版物可能会降低其普遍适用性。

Conclusions

This review found no significant differences in diabetes incidenceor other key indicators of T2DM, with certainty of evidence varying from moderate to low.

这项综述发现，在糖尿病发病率或其他2型糖尿病（T2DM）的关键指标上没有显著差异，证据的确定性从中等到低不等。

Future studies should test integrated screening, referral, and social support strategies in routine care for high-risk groups.

未来的研究应在高危群体的常规护理中测试综合筛查、转诊和社会支持策略。