Can structural barriers to healthy eating and exercise be addressed to improve type 2 diabetes mellitus (T2DM) self-management? A scoping review published in Diabetes, Obesity and Metabolism found limited but emerging evidence that broader, multi-level interventions may help support diabetes self-management, particularly for nutrition-related behaviors.

The review evaluated structural interventions targeting social determinants of health (SDOH) that could influence two key self-management strategies: consumption of nutrient-dense foods and participation in physical activity. Searches of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Google Scholar, PubMed, and Web of Science identified studies focused on structural approaches for adults with T2DM.

Only four studies met the inclusion criteria. Two focused on improving access to healthy foods, while two assessed multi-component, multi-domain, and multi-level interventions. No eligible structural interventions specifically targeting physical activity uptake were identified.

Findings showed varying evidence regarding best practices and supportive elements embedded within interventions. However, the available data suggested that approaches addressing multiple determinants beyond the individual level may offer added value for diabetes self-management.

The review concluded that no single strategy is likely to fit all populations. Tailored interventions that center affected communities and address broader contributory factors may improve nutrition behaviors and related outcomes, but further research is needed, especially in underserved populations.