Association between a healthy lifestyle and prognosis in patients with Diabetes Mellitus

Abstract

Diabetes mellitus (DM) is a global public health concern due to its high prevalence and morbidity and mortality, primarily resulting from its macrovascular and microvascular complications. In Brazil, DM imposes substantial costs on the healthcare system and ranks among the leading causes of hospitalization. Evidence suggests that lifestyle modifications are effective in preventing the onset and progression of the disease, as well as in improving patients' quality of life. The objective of this study was to analyze the effects of adopting a healthy lifestyle on the prognosis of individuals with type 1 diabetes (DM1), type 2 diabetes (DM2), and prediabetes. This is a narrative literature review. The research question was structured using the PICO strategy. The search was conducted in the MEDLINE, LILACS, BVS, and SciELO databases, using the descriptors “diabetes,” “healthy lifestyle,” “physical activity,” and “diet,” combined with the Boolean operator “AND.” Original studies published between 2019 and 2024 in Portuguese, English, or Spanish were included, provided they addressed healthy lifestyle habits and their effects on the prognosis of DM. Adopting a healthy lifestyle shows consistent effects on the prognosis of DM1, DM2, and prediabetes. In patients with DM2, regular physical activity and caloric restriction promote reductions in HbA1c, weight loss, and, in some cases, disease remission. In prediabetes, interventions based on diet and physical activity have been shown to effectively reduce progression to DM2. Among individuals with DM1, although treatment depends on insulin use, regular physical activity improves cardiorespiratory fitness, reduces cardiovascular risks, and is associated with lower overall mortality, provided that therapeutic adjustments are made to prevent hypoglycemia. The combination of factors such as a balanced diet, maintaining a healthy weight, regular exercise, and smoking cessation reduces the risk of both microvascular and macrovascular complications in all forms of the disease. Therefore, lifestyle modification strategies should be incorporated into the therapeutic plan of individuals with DM as effective components to slow disease progression, prevent adverse outcomes, and enhance quality-adjusted survival in this population.