Lifestyle interventions to prevent gestational and type 2 diabetes among migrant women from low- and middle-income countries: a systematic review.

Clinical Snapshot

Key Findings

• P Value: Not reported for pooled analysis

• Effect Size: Modest improvements reported but inconsistent across studies

• Primary Outcome: Behavioural and metabolic outcomes related to GDM and T2DM prevention/management

• Nnt Or Sensitivity: Multi-component interventions (dietary + physical activity + cultural adaptation) showed greater improvements than single-component programmes

• Confidence Interval: Not reported - narrative synthesis only

Clinical Application

Moderate - requires culturally adapted resources, bilingual staff, and community engagement which may be resource-intensive Highly relevant given Australia's diverse migrant population; aligns with RACGP diabetes prevention guidelines and could inform culturally responsive care models within Medicare framework Migrant women from LMICs living in Australia, particularly those at risk of or with GDM/T2DM

Abstract

Migrant women from low- and middle-income countries (LMICs) living in high-income settings experience disproportionately high risk of gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM). This review aimed to identify and synthesise culturally adapted lifestyle interventions for preventing or managing GDM and T2DM among migrant women from LMICs, focusing on intervention components, cultural adaptation strategies, and behavioural and metabolic outcomes. Five databases (PubMed, Embase, Scopus, CINAHL, Cochrane Central) were searched using Preferred Reporting Items for Systematic reviews and Meta-Analysis 2020 guidelines. Eligible studies included experimental designs involving lifestyle interventions delivered to migrant women from LMICs in high-income countries, reporting outcomes related to GDM or T2DM targeting behaviour change. Data were synthesised narratively; study quality was appraised using RoB2 for RCTs and a structured narrative approach for non-randomised designs. Certainty of evidence was evaluated using GRADE. Eight studies met the inclusion criteria. Sample sizes ranged from 28 to 641 participants. Intervention duration varied from 6 weeks to 12 months. Most interventions incorporated atleast one culturally tailored component, such as bilingual delivery, culturally adapted dietary education, or community-based engagement. Improvements were reported across dietary behaviours, physical activity, glycaemic measures, or diabetes-related knowledge; however, effect sizes were modest and inconsistent. Interventions combining dietary modification, physical activity, and culturally adapted delivery demonstrated greater improvements than exercise-only or digital-only programmes. Overall certainty of evidence ranged from low to moderate. Culturally adapted, multi-component lifestyle interventions show promise for improving behavioural and metabolic outcomes among migrant women from LMICs; however, the evidence base remains limited. Main findings: Culturally adapted, multi-component lifestyle interventions show modest but inconsistent improvements in behavioural and metabolic outcomes among migrant women from low- and middle-income countries with overall low-to-moderate certainty of evidence.Added knowledge: This review highlights cultural adaptation as a key feature of intervention effectiveness and identifies important evidence gaps, including limited high-quality studies and challenges in comparing heterogeneous interventions.Global health impact for policy and action: Policies should prioritise scalable, culturally responsive interventions – such as bilingual and community-based approaches – to reduce diabetes disparities and improve maternal health outcomes in migrant populations.

References

1. 1.Akombi-Inyang, B. J., Mumu, S., Tesema, A. G., & Merom, D. (2026). Lifestyle interventions to prevent gestational and type 2 diabetes among migrant women from low- and middle-income countries: a systematic review. Global Health Action, Article 2658925. https://doi.org/10.1080/16549716.2026.2658925