Effectiveness of Lifestyle Modifications on Type 2 Diabetes Mellitus in Smoking Individuals Aged 45-60 Years

Effectiveness of lifestyle modifications on the treatment of type 2 diabetes mellitus among smoking individuals ageing 45-60
years

Abstract
The main objective of the systematic review is to determine the challenges faced with type 2 diabetes. The study analyses the
effectiveness of lifestyle modification in response to diagnosis and maintaining behavior change for a healthy life. The changes in
lifestyle behavior have been discussed and investigated to understand the impact of type 2 diabetes. People with smoking habits
between the age of 45 to 60 years face severe effects due to type 2 diabetics.
In the review studies using qualitative methods have been used to better understand the effectiveness of change in the lifestyle. It is
vital that the changes are made in the weight, proper exercise, and moderate to intense workout for at least 2hours a week. It is
advisable from data that diet is to be followed by including fruits and vegetables. However, it is identified that cigarette smoking
impacts health and leads to behavior change which is not suitable for treating type 2 diabetics.
As a part of the result, it is noted that improving nutrition and including vegetables helps to reduce weight. Quitting smoking is vital as
it will positively impact health behavior. It has also resulted that reducing stress, improving sleep, proper diagnosis, exercise, regular
monitoring of blood pressure, and limiting the smoking ability helps the type 2 diabetics patients.
It can thus be concluded that lifelong diseases with high risk can be reduced through leading a proper lifestyle. Controlling the glucose
level by following a healthy diet, weight loss, performing exercises will positively influence healthy blood glucose levels and reduce
the risks associated with type 2 diabetics.

Table of Contents
Abstract........................................................................................................................................................................................................2
Chapter 1: Introduction................................................................................................................................................................................5
Background of the study..........................................................................................................................................................................5
Aim and Objectives.................................................................................................................................................................................8
Problem of this Study..............................................................................................................................................................................8
Rationale of this Study.............................................................................................................................................................................9
Chapter 2: Research methodology.........................................................................................................................................................15
Introduction............................................................................................................................................................................................15
Step of Undertaking Systematic Review...........................................................................................................................................21
Limitations.............................................................................................................................................................................................22
Research Process...................................................................................................................................................................................23

Search Terms.........................................................................................................................................................................................23
Inclusion and Exclusion Criteria...........................................................................................................................................................24
Search Strategy......................................................................................................................................................................................25
Study selection.......................................................................................................................................................................................25
Data Extraction......................................................................................................................................................................................26
Findings from Secondary Data..............................................................................................................................................................40
Impact of Smoking on Diabetes........................................................................................................................................................40
Impact of Diet on Diabetes................................................................................................................................................................40
Impact of Physical Activity on Diabetes...........................................................................................................................................41
Chapter 5 Discussion.................................................................................................................................................................................43
Chapter 6: Conclusion...............................................................................................................................................................................49
Policy implications................................................................................................................................................................................54
References..................................................................................................................................................................................................55

Chapter 1: Introduction
Background of the study
The occurrence of diabetes is increasing globally, resulting in diabetes-related complications and even an impact on healthcare costs.
It is acknowledged that the number of people who have diabetes has risen from 108 million in 1980 to 422 million in 2014. Between
2000 to 2016, there was a 5% increase in premature mortality rate from diabetes (Wang & et. Al., 2018). It is even analyzed that
adults over 18 years are increasingly suffering from these diseases, which enhanced from 4.7% in 1980 to 8.5% in 2014(WHO, 2021).
In 2019, diabetes had led to the death of 1.5 million people, wherein 2.2 million death took place due to higher blood glucose levels in
2012. WHO has also estimated that diabetes was the 4th leading reason for the death of people in 2016? It is acknowledged that more
than 4.8 million people have diabetes, whereby more than 700 people prematurely die with diabetes every week (WHO, 2021). Type 2
diabetes is more commonly found among older individuals as compared to younger ones.
Type 2 Diabetes is a lifelong disease that has increased the mortality rate. An unhealthy lifestyle like drinking alcohol is harmful to
this disease, where a moderate amount of alcohol enhances insulin sensitivity and HDL cholesterol level. The heavy intake of alcohol
improves triglyceride levels and even impair the metabolism of glucose and carbohydrate (Figueira & et al.,2017). Smoking is also
linked with an increased risk of diabetes mellitus, where frequent smokers who intake 20 cigarettes per day possess a maximum
chance to attain diabetes. On the other hand, Occasional smokers are relatively at lesser risk of type-2 diabetes ( Figueira & et
al.,2017).

Apart from smoking and drinking alcohol. Weight gain has also acted as a significant issue for people with type 2 diabetes. As per the
Third National Health and Nutrition Examination Survey, most people with diabetes are obese or overweight. Type 2 diabetes with
overweight and obese patients can significantly improve glycemic control and plasma lipid when they decline the weight (Public
Health Agency of Canada Diabetes in Canada, 2016). It is underlined that body weight enhances with age and oral hypoglycemic
drugs lead to weight gain, thus, encouraging the patients to attain and maintain healthy weights should be of prime priority for every
diabetes care programmed.
Diabetes mellitus is a significant issue faced by modern civilization that has led to various complications and it can be seen in various
walks of the society as a common health issue (Rinaldi et al., 2016). Medical treatment alone cannot, however, lead to the cure of
diseases, but changes in lifestyle factors help in preventing diabetes. When an individual controls the glucose strictly, then it can avoid
the progression of issues associated with diabetes (Rinaldi et al., 2016). There is evidence that a healthy lifestyle following a healthy
diet and achievement of modest weight loss and regular physical activities helps in maintaining blood glucose levels and decline the
risk of type 2 diabetes (Rinaldi et al., 2016).
Lifestyle modification can reduce energy intake whereby control in diet and performing of physical exercise are the principal therapy
for overweight and obese patients who have Type-2 Diabetes. Research states that there are protective mechanisms which include
physical activities, anti-inflammatory strategy, reduction of weight via intake of low-calorie diets, and also a healthy eating pattern

that should be followed. The prevention of type 2 diabetes can be possible through modification of lifestyle and medication along with
dietary supplements, exercise, and also herbal medicines (Meier & Bonadonna, 2013).
Long-term diabetes management includes health behaviors like physical activities, weight management, smoking cessation, healthy
eating, etc. Regular physical activities assist in preventing type 2 diabetes, enhances blood pressure control, and also reduce the
complication risk (Fadare, Olamoyegun & Gbadegesin., 2015). Moderate to vigorous physical activities decline the risk of
cardiovascular mortality, blood pressure, smoking status and also control cholesterol level. Weight management and modification of
diet like the adoption of Mediterranean or low-glycemic index eating pattern is seen to be effective in decline cardiovascular disease
risk (Thamer & et.al., 2017). Smoking is a well-established and significant risk for cardiovascular disease, and people who have type
2 diabetes should quit smoking.
There are various developing and under-developed countries where diabetic patients are not aware of the benefits of lifestyle change
in glycemic control. There is a higher need to educate people regarding disease and various management options (Forouhi et al 2016).
Government should also focus upon educating students from the earlier stage about negative impacts of diabetes through upgrading
education system. Educating campaigns can also be effective to spread awareness regarding healthy lifestyle. Apart from this,
receiving the diagnosis of diabetes from the health professionals even enhances people’s awareness for the need to change lifestyle
and could act as motivating factors. A study has reported that more than 60% of the people who are of age 45-65 years and are