Abstract

Type 2 diabetes mellitus (T2DM) represents a major and escalating global public health challenge, driven largely 
by modifiable lifestyle and environmental factors. This narrative review synthesizes current evidence on 
prevention strategies for T2DM across individual, clinical, community, and policy levels. Lifestyle modification, 
particularly dietary change, weight management, physical activity, and behavioral support, remains the 
cornerstone of primary prevention and has demonstrated sustained risk reduction in diverse populations. 
Pharmacologic interventions, including metformin and newer agents such as GLP-1 receptor agonists, offer 
additional benefit for individuals at high metabolic risk when combined with lifestyle approaches. Surgical 
interventions, notably bariatric and metabolic surgery, provide effective risk reduction in selected populations with 
severe obesity. Beyond individual-level interventions, community- and policy-based strategies targeting food 
environments, urban planning, public health education, and screening programs play a critical role in shaping 
population-wide risk profiles. However, significant challenges persist, including inequities in access, long-term 
adherence, variability in outcomes, and gaps in implementation and evaluation. Addressing these challenges 
requires integrated, culturally tailored, and sustainable prevention frameworks supported by translational research 
and cross-sector collaboration. Strengthening the reach and equity of evidence-based interventions is essential to 
curb the growing global burden of type 2 diabetes.