Role of Diet and Exercise in Management of Diabetes Mellitus: A Narrative Review Running Title : Lifestyle Modification Glycaemic Control

Abstract

Objective: To evaluate the role of diet and exercise as essential non-pharmacological strategies in the management of diabetes mellitus, with emphasis on their effects on glycaemic control, insulin sensitivity, and prevention of complication. Methodology: This review synthesizes proof from recent clinical researches , population based studies and regional data from Pakistan assessing dietary patterns, micronutrients intake, and physical activity in individuals with type 2 diabetes mellitus (T2DM). The review incorporate findings on micronutrients composition, glycemic index-based dietary planning, micronutrients supplementation, and structured physical intervention, including supervised exercise programs and lifestyle-modification trials [1,2,5,13]. Regional observational studies evaluating dietary habits, socioeconomics factors, and glycemic outcomes among Pakistani diabetic populations were also included [7,18, 23,27]. Results: Dietary strategies focusing on low glycemic index carbohydrates, high dietary fiber, unsaturated fats, and balanced protein intake significantly improve   glycemic   control   and cardiovascular    health[1,2,5]. Micronutrients such as vitamins C, D, B-12, folate, and antioxidants further support metabolic regulation and reduce complications [4,16].

Regular physical activity (>150 minutes/week) improves glucose uptake, insulin sensitivity, lipid profile and blood pressure [1,13]. Evidence from Pakistan indicates that high carbs intake, low fruit and vegetable consumption, sedentary lifestyle and low socioeconomic status are associated with poor glycemic control [7,18,23]. Supervised                            lifestyle interventions demonstrate greater improvements in HbA1c, insulin sensitivity and lipid parameters compared to unsupervised approaches [13].

Overall, effective diabetes management requires an integrated approach combining pharmacotherapy with individualized diet planning, regular physical activity, patient education and culturally adapted public health strategies for early diagnosis and preventions.