Promoting dietary changes is a cornerstone of managing dysglycemia, with a focus on macro and micronutrient composition and glycemic response modulation (33). The incorporation of low-glycemic index (GI) foods and meals, characterized by gradual carbohydrate absorption and lower postprandial glucose excursions, has been shown to improve insulin sensitivity and reduce HbA1C levels, including patients with established T1D (34). Foods such as legumes, whole grains, and non-starchy vegetables delay gastric emptying and promote a more stable release of glucose, primarily through their fiber content and slower digestion rates (35). Moreover, the inclusion of polyunsaturated fatty acids (PUFAs), such as omega-3 (eicosapentaenoic acid and docosahexaenoic acid) and omega-6 fatty acids – observing the right ratio, has demonstrated efficacy in enhancing insulin receptor signaling by incorporating into cell membrane phospholipids, thereby improving membrane fluidity and downstream insulin signaling cascades, particularly the PI3K/Akt pathway. Monounsaturated fatty acids (MUFAs), predominantly found in olive oil, avocados, and nuts, exert beneficial effects on dysglycemia by reducing oxidative stress and inflammation through the modulation of nuclear factor-kappa B (NF-κB) and activation of peroxisome proliferator-activated receptors (PPARs) (36). Additionally, polyphenol-rich diets, comprising flavonoids and anthocyanins, further support glucose homeostasis by inhibiting alpha-glucosidase, enhancing endothelial function, and modulating gut microbiota composition (37). The synergistic effects of these dietary components underscore the potential of personalized nutrition tailored to cultural and regional preferences to ensure widespread adoption. Strategies in mitigating dysglycemia and preventing its progression to diabetes. For instance, local food staples have been integrated into diet plans to make healthier choices accessible and affordable. Educational campaigns focused on portion control, nutritional literacy, and the long-term benefits of balanced meals have been pivotal in encouraging sustainable eating habits. By addressing socioeconomic barriers to accessing fresh and nutritious foods, these interventions not only support individuals but also create ripple effects across communities (38, 39).

Emerging evidence highlights the significant influence of nutrition and food literacy on glycemic control, particularly concerning HbA1c levels in individuals with diabetes. A randomized controlled trial in Thailand demonstrated that a Collaborative Learning-Based Food Literacy Enhancement Program (CLFLEP) led to substantial improvements in healthy eating behaviors and reductions in HbA1c among older adults with uncontrolled type 2 diabetes (40). The findings of this study highlight the effectiveness of structured food literacy interventions in enhancing metabolic outcomes. Similarly, a study found that patients with higher food literacy scores experienced more favorable changes in HbA1c levels compared to those with lower scores, emphasizing the role of food literacy in glycemic management (41). Additionally, research has shown that individuals with inadequate health literacy tend to have higher HbA1c levels and poorer lipid profiles, suggesting that health literacy is a critical determinant of diabetes control (42). Collectively, these findings suggest the necessity of incorporating nutrition and food literacy education into diabetes care strategies to improve glycemic control and overall health outcomes.

Structured exercise programs have demonstrated significant benefits in reducing insulin resistance and improving glucose metabolism. Community-led initiatives, such as walking groups and fitness clubs, provide accessible and low-cost opportunities for physical activity. Workplace wellness programs have been implemented to encourage employees to incorporate movement into their daily routines, while school-based physical education programs instill healthy habits early in life. The scalability of these programs makes them ideal for large-scale adoption, ensuring that physical activity becomes a regular part of individuals’ lives (43–45).

The integration of continuous glucose monitoring (CGM) systems has revolutionized personal glycemic management. These devices provide real-time data on glucose levels, allowing individuals to make informed decisions about their diet, exercise, and medication. By fostering a sense of autonomy and accountability, CGM systems empower individuals to actively participate in managing their health. Additionally, mobile health apps and wearable technologies further enhance these systems, offering personalized feedback and promoting long-term adherence to glycemic control strategies (46, 47).

Equipping healthcare professionals with knowledge and tools to manage dysglycemia is essential for improving patient outcomes. Comprehensive training programs have focused on evidence-based, patient-centered care, enabling providers to offer personalized treatment plans that address each patient’s unique needs. These programs include workshops, certifications, and continuous medical education modules that emphasize the latest advancements in glycemic management. By strengthening clinical expertise, these initiatives have enhanced the overall quality of care and patient satisfaction (48–50).

Building strong partnerships between clinicians and community leaders has been instrumental in raising awareness about dysglycemia and encouraging community participation in health initiatives. Local leaders, trusted by their communities, serve as advocates for preventive measures such as early screenings, healthy eating, and regular exercise. Collaborative events, such as health fairs and awareness campaigns, provide platforms for disseminating information and promoting active engagement (51, 52).

Culturally adapted counseling services and group education sessions have been vital in addressing patient concerns and fostering behavioral change. For example, diabetes educators work closely with individuals and families to provide tailored advice that aligns with cultural norms and dietary practices. Group sessions create supportive environments where individuals can share their experiences, learn from peers, and stay motivated to adhere to treatment plans. These localized efforts bridge gaps in healthcare delivery, ensuring that interventions are relevant, relatable, and effective (53, 54).

The implementation of sugar taxes has proven to be a highly effective strategy for reducing the consumption of sugary beverages and processed foods. By increasing the cost of these products, governments disincentivize their purchase, encouraging consumers to opt for healthier alternatives. One of the most well-documented examples is Mexico’s sugar tax, introduced in 2014, which led to an average 7.6% decline in sugary drink purchases in the first year and a 10.2% reduction among low-income households, groups most vulnerable to diet-related non-communicable diseases (55–58). In the United Kingdom, the Soft Drinks Industry Levy prompted manufacturers to proactively reduce sugar content in beverages, resulting in a 29% drop in total sugar purchased from soft drinks between 2015 and 2018 (59).

Other countries have also reported measurable improvements in public health outcomes (60–65). The implementation of South Africa’s Health Promotion Levy (HPL) in April 2018 has been associated with significant reductions in sugar consumption from sugar-sweetened beverages (SSBs) (66). A study analyzing household purchase data from 2014 to 2019 found that the mean daily sugar intake from taxable beverages decreased from 16.25 grams per capita before the HPL announcement to 10.63 grams per capita after its implementation (66). Additionally, the volume of taxable beverage purchases declined from 518.99 mL to 443.39 mL per capita per day over the same period. These reductions were more pronounced among lower socioeconomic groups, indicating the HPL’s potential to improve health equity. In Chile, the implementation of the Law of Food Labeling and Advertising in 2016, which introduced mandatory front-of-package warning labels for products high in sugars, sodium, saturated fats, or calories, resulted in a significant reduction in the consumption of unhealthy beverages (67). A study evaluating purchases from 2015 to 2017 found a 23.7 percent decline in the volume of labeled “high-in” beverage purchases, corresponding to a reduction of 22.8 milliliters per capita per day. Additionally, there was a 27.5% decrease in calories purchased from these beverages (67). These reductions were observed across all education levels, indicating the broad population-level impact of the policy. The study suggests that comprehensive labeling laws can effectively shift consumer behavior and contribute to improved dietary patterns and public health outcomes. The Philippines’ sugar-sweetened beverage tax, also enacted in 2018, produced a marked decline in sugary drink sales while simultaneously boosting water and unsweetened beverage consumption (64).

In the United States, local interventions have similarly demonstrated success. In Berkeley, California, the implementation of a local sugar tax in 2015 resulted in a 9.6% reduction in sugary drink consumption in the first year, accompanied by a 15.6% increase in water intake (68). These diverse case studies collectively illustrate that fiscal measures such as sugar taxation can effectively drive both consumer behavior change and industry reformulation, contributing to reduced caloric intake from added sugars and lowering the overall burden of dysglycemia and other non-communicable diseases. As more regions adopt such policies, their potential to promote healthier lifestyles and reduce the burden of non-communicable diseases continues to grow (69, 70).

To complement sugar taxes, subsidies for nutritious foods have been introduced to promote equitable access to healthy diets. Programs such as the U.S. Supplemental Nutrition Assistance Program (SNAP) provide financial incentives for purchasing fruits, vegetables, and whole grains, making these options more affordable for low-income families. In Brazil, government-supported initiatives have linked local farmers to urban food distribution systems, ensuring the availability of fresh produce in underserved areas. By reducing the cost barrier to healthy eating, these subsidies address socioeconomic disparities in diet quality and support long-term health improvements (70–74).

Other countries have also implemented similar initiatives with success. In the United Kingdom, the Healthy Start scheme provides low-income families with vouchers to purchase fresh fruits, vegetables, milk, and formula, improving maternal and child nutrition. Finland’s fruit and vegetable subsidy program has encouraged healthier eating habits, leading to significant increases in fruit and vegetable consumption, particularly among children and adolescents (75–78).

In India, the Public Distribution System (PDS) subsidizes essential staples like rice, wheat, and pulses for low-income populations while piloting programs to include nutrient-rich foods such as fortified grains and edible oils. Rwanda’s Girinka program provides smallholder farmers with livestock subsidies, indirectly boosting dietary diversity by increasing access to animal-source foods like milk and eggs (79–81).

In Australia, remote indigenous communities benefit from subsidies on healthy foods through programs like the Outback Stores initiative, which ensures affordable prices for fresh produce in isolated areas. These global examples highlight how strategic subsidies can improve diet quality, reduce health disparities, and promote sustainable, healthier eating behaviors across diverse populations (82, 83).

Besides sugar taxes and healthy food subsidies, innovative strategies are emerging to promote equitable access to healthy diets and transform food environments. One novel concept is “produce prescription programs,” which integrate healthcare and nutrition by allowing physicians to “prescribe” fresh fruits and vegetables as part of medical treatment plans. These prescriptions are often redeemable for free or discounted produce through partnerships with local grocery stores and farmers’ markets. Early implementations in the United States, such as the Fresh Food Pharmacy initiative, have demonstrated success in improving dietary intake and glycemic control among patients with diabetes (84–87).

Another cutting-edge approach is the development of “smart subsidies” powered by artificial intelligence (AI) and data analytics. These programs use AI to analyze individual purchasing behaviors and provide personalized discounts or incentives for healthier choices directly at the point of sale. For example, a pilot program in Europe used machine learning algorithms to identify high-sugar product purchases and automatically apply discounts to healthier alternatives during checkout, effectively nudging consumers toward better options (88, 89).

A particularly innovative concept is the “health footprint tax,” which extends beyond sugar to include the environmental and health impacts of food production and consumption. This approach assigns taxes or incentives based on a food’s combined impact on health and sustainability. For instance, ultra-processed foods with high environmental costs and negative health outcomes would incur higher taxes, while locally sourced, minimally processed, nutrient-rich foods would receive subsidies (90, 91).

Finally, the use of behavioral economics in school cafeterias, known as “choice architecture,” is gaining traction. By strategically placing healthier options at eye level or offering smaller portions of unhealthy foods as defaults, researchers have found significant improvements in dietary choices among children. This approach capitalizes on subconscious decision-making to instill healthier eating habits early in life (92, 93).

These novel strategies push the boundaries of traditional public health measures, offering transformative potential to improve diets, reduce chronic disease burdens, and ensure equity in food systems. They also emphasize the importance of integrating technology, behavioral science, and cross-sector collaboration into modern nutrition policy frameworks.

Restricting the marketing of unhealthy foods, particularly to children, is a crucial policy intervention. Children are highly susceptible to advertising, and exposure to marketing for high-sugar, high-fat, and highly processed products influences their preferences and eating habits. Countries such as Norway and Chile have implemented strict regulations banning junk food advertisements during children’s programming and requiring clear warning labels on unhealthy products. These measures have reduced the appeal of such products and encouraged families to make healthier food choices. Limiting exposure to these advertisements protects vulnerable populations and reduces the normalization of unhealthy diets (94, 95).

Collaborations between governments and the private sector have played a pivotal role in reformulating products and improving nutritional labeling. For instance, initiatives like the European Union’s salt reduction framework have engaged food manufacturers in reducing salt levels in processed foods while maintaining taste and consumer acceptance. Similarly, partnerships in the U.S. have led to the introduction of front-of-pack labeling systems that highlight nutritional information, enabling consumers to make more informed choices. These collaborations align industry interests with public health goals, fostering a collective effort to improve population health (96, 97).

Physical environments significantly influence lifestyle behaviors, and improving access to recreational facilities and walkable urban designs can promote healthier living. Investments in public parks, bike lanes, and pedestrian-friendly infrastructure encourage physical activity and reduce sedentary behavior. For example, the Netherlands’ extensive cycling infrastructure has been linked to lower obesity rates and better cardiovascular health. In the U.S., initiatives such as the “Complete Streets” program prioritize designing streets that accommodate pedestrians, cyclists, and public transit users. These efforts create environments that support active lifestyles, ultimately contributing to better glycemic control and overall health (98).

One of the most significant impacts has been the reduction in hospital admissions related to diabetes complications, such as cardiovascular events, renal failure, and neuropathy. By promoting preventive measures, such as lifestyle changes and early screenings, healthcare systems have experienced a tangible decrease in the burden of acute and chronic complications. Participants in community-based glycemic control programs have shown improved glycemic stability, evidenced by lower HbA1c levels and reduced incidence of hyperglycemic and hypoglycemic episodes. Additionally, enhanced glycemic control has translated to better physical and cognitive health, enabling individuals to remain active contributors to the workforce. Employers have reported improved productivity and reduced absenteeism, underscoring the broader societal benefits of addressing dysglycemia (99, 100).

Cost-effectiveness analyses have highlighted the economic advantages of glycemic control initiatives. Lower medication costs, resulting from better glycemic stability and fewer complications, have significantly reduced the financial burden on both individuals and healthcare systems. For instance, implementing continuous glucose monitoring (CGM) technologies and subsidizing healthy foods have demonstrated substantial returns on investment by preventing costly interventions for advanced diabetes-related conditions. Fewer hospitalizations and disability claims have further alleviated economic strain, while productivity gains from healthier workforces have contributed to sustained economic growth. These findings emphasize the long-term economic viability of investing in preventive and management-focused dysglycemia programs (101).

Addressing healthcare disparities has been a critical focus of these initiatives, with efforts aimed at reaching underserved populations who face the highest risks of dysglycemia and its complications. Expanding access to affordable technologies, such as CGMs and early diagnostic tools, has been instrumental in reducing inequities. Subsidized programs for low-income families have improved access to nutritious foods and healthcare services, enabling vulnerable groups to participate in glycemic control interventions. However, persistent gaps in access remain a challenge, highlighting the need for continued investment in equitable healthcare delivery models (102).