Evidence-Based Nutrition Patterns and Lifestyle Counselling in Type 2 Diabetes Care: Bridging Gaps With Personalized, Digital, and Lmic-Tailored Innovations – A Systematic Review

Type 2 diabetes (T2D) affects over 500 million people globally, with India facing 11-15% prevalence amid rapid urbanization and lifestyle shifts. while RCTs endorse low-glycemic index with Mediterranean low-carbohydrate and plant-based diets for HbA1c reductions of 0. 5-1. 2%, weight loss, and cardiovascular benefits. persistent gaps include poor long-term adherence (>40% dropout), unaffordable Low- and Middle-Income Countries adaptations (e. g. , olive oil, nuts), and limited personalization for genetic/ethnic factors like key protein-coding gene located on chromosome 10q25. 2–q25. 3 variants. This PROSPERO-registered systematic review synthesizes 2023-2026 RCTs, network meta-analyses and cohorts (n>50 trials) from PubMed, Embase, Cochrane, and grey literature up to January 2026, evaluating glycaemic control, adherence, cost-effectiveness, and quality of life via GRADE-rated meta-analyses; LGI-Mediterranean hybrids excelled in Low- and Middle-Income Countries with digital interventions (apps, wearables) enhancing adherence by 25-35% through real-time feedback. We propose hybrid AI-driven models for Indian contexts—culturally adapted low-glycaemic index. plates featuring millets and lentils, pharmacogenomics-integrated mobile apps, and rural tele-counselling—leveraging predictive analytics for relapse prevention and pharmacoeconomic gains Incremental Cost-Effectiveness Ratio less than 500 per Quality-Adjusted Life Year), thereby bridging evidence-to-practice gaps with scalable, equity-focused innovations to mitigate Type 2 diabetes epidemic.