Toward Integrated Diabetes Care: A Comprehensive Review of Strategies for Prevention, Diagnosis, Treatment, and Follow-up

Diabetes mellitus affects >500 individuals globally and remains a major health burden. In Saudi Arabia, recent estimates indicate that >18% of adults have diabetes, reflecting rising lifestyle-related risk factors and underscoring the urgency of national response efforts. Despite advances in prevention and treatment, outcomes remain suboptimal due to fragmented care pathways, diagnostic delays, therapeutic inertia, and disparities in access—particularly in low- and middle-income countries. This narrative review synthesizes recent developments in diabetes prevention, diagnosis, treatment, and follow-up, with an emphasis on clinical effectiveness, implementation barriers, and future directions. A purposive literature review was conducted using PubMed, Scopus, and the Web of Science to identify peer-reviewed articles, clinical trials, meta-analyses, and regional and global guidelines published between 2012 and 2025. Sixty-seven sources were included, prioritizing high-quality trials and landmark recommendations from the American Diabetes Association and World Health Organization. Lifestyle modification remains the cornerstone of prevention, but faces challenges in adherence and scalability. Diagnostic innovations, such as continuous glucose monitoring and artificial intelligence, show promise yet are limited by cost and variability. Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors provide superior cardio-renal outcomes but remain underutilized. National digital health platforms in Saudi Arabia, such as Sehhaty, are emerging as key tools to enhance a more integrated continuum of care.