The impact of pre-diabetes diagnosis on behaviour change: an integrative literature review

Type 2 diabetes is a growing global problem that not only affects individuals but also has an impact upon the economic health of countries. The number of people developing type 2 diabetes can be reduced by up to by 80%; this can be achieved by targeting those who are ‘at risk’. This reduction can be achieved by appropriate lifestyle changes to diet and physical activity. It is not known what the impact of being informed of a diagnosis of pre-diabetes has on an individual's motivation to make appropriate lifestyle changes. The aim of this study was to assess whether having the diagnosis of pre-diabetes encourages or empowers people to make appropriate lifestyle changes to prevent progression to a diagnosis of type 2 diabetes. Employing a systematic approach, an integrative literature review was undertaken using a standard retrieval and appraisal method. The studies demonstrated that pre-diabetes was found to be a challenging concept by patients and nurses alike. Lack of knowledge and support, along with patients’ perceived barriers, had an impact upon the various motivation and self-efficacy behaviours towards lifestyle changes. The integrative review found that more education and support are required to motivate lifestyle change in the person with pre-diabetes. This, however, does not need to be medicine led; use of peer and community based programmes could be not only cheaper, but also have the ability to provide potentially long-term support for people, and would provide continued reduced risk. Intervention needs to ensure that it is provided at an appropriate level to account for cultural, social and gender needs. Innovative approaches need to be considered to reduce the number of people who are diagnosed with pre-diabetes from progressing to type 2 diabetes and its associated potential complications.