Nurse-led behavioural support for lifestyle self-management in adults with type 2 diabetes mellitus: an integrative review.

BACKGROUND: Type 2 diabetes mellitus (T2DM) requires sustained self-management across diet, physical activity, body weight, glucose monitoring, and medication-taking behaviours. Although lifestyle recommendations are central to diabetes care, patients often need professional support to translate advice into feasible, culturally acceptable, and safe daily routines. AIM: To synthesize evidence on lifestyle interventions and nurse-led behavioural support for adults with T2DM, and to clarify implications for nursing self-management support and service delivery. METHODS: An integrative review with narrative synthesis was conducted. We searched Embase, the Cochrane Library, Scopus, Web of Science, WanFang Data, VIP, PubMed, and CINAHL for literature published between 2006 and 2026. To strengthen currency and nursing relevance, we added high-relevance, peer-reviewed studies on nurse-led education, behavioural coaching, medication adherence, technology-enabled support, and self-management. Twenty articles were included, comprising randomized and quasi-experimental studies, systematic reviews and meta-analyses, narrative reviews, position statements, and analytic studies. Data were summarized using inductive content analysis and appraised narratively for methodological clarity, relevance, and nursing implications; no design-specific formal risk-of-bias assessment, GRADE assessment, or quantitative synthesis was undertaken. RESULTS: Four interrelated themes were identified: physical activity and dietary habits; weight management and obesity control; structured patient education, behavioural coaching and empowerment; and medication-related support, glucose-monitoring guidance and technology-enabled follow-up. Lifestyle interventions provided the behavioural foundation for T2DM management. Nurse-led support may strengthen implementation by helping patients set realistic goals, interpret glucose data, address medication concerns, adapt recommendations to cultural and family routines, and maintain follow-up contact. CONCLUSION: This integrative synthesis suggests that structured lifestyle interventions and nurse-led behavioural support may be useful complementary components of T2DM care. Nurses may help translate lifestyle recommendations into feasible self-management routines, but the review does not establish comparative effectiveness or superiority over other delivery models. Findings should therefore inform practice-oriented nursing support rather than be interpreted as a graded clinical recommendation.