Abstract
BACKGROUND: Type 2 Diabetes Mellitus (T2DM) remains a critical global health challenge, necessitating robust predictive models to enable early detection and personalized interventions. This study presents a comprehensive bibliometric and systematic review of 33 years (1991-2024) of research on machine learning (ML) and artificial intelligence (AI) applications in T2DM prediction. It highlights the growing complexity of the field and identifies key trends, methodologies, and research gaps. METHODS: A systematic methodology guided the literature selection process, starting with keyword identification using Term Frequency-Inverse Document Frequency (TF-IDF) and expert input. Based on these refined keywords, literature was systematically selected using PRISMA guidelines, resulting in a dataset of 2,351 articles from Web of Science and Scopus databases. Bibliometric analysis was performed on the entire selected dataset using tools such as VOSviewer and Bibliometrix, enabling thematic clustering, co-citation analysis, and network visualization. To assess the most impactful literature, a dual-criteria methodology combining relevance and impact scores was applied. Articles were qualitatively assessed on their alignment with T2DM prediction using a four-point relevance scale and quantitatively evaluated based on citation metrics normalized within subject, journal, and publication year. Articles scoring above a predefined threshold were selected for detailed review. The selected literature spans four time periods: 1991-2000, 2001-2010, 2011-2020, and 2021-2024. RESULTS: The bibliometric findings reveal exponential growth in publications since 2010, with the USA and UK leading contributions, followed by emerging players like Singapore and India. Key thematic clusters include foundational ML techniques, epidemiological forecasting, predictive modelling, and clinical applications. Ensemble methods (e.g., Random Forest, Gradient Boosting) and deep learning models (e.g., Convolutional Neural Networks) dominate recent advancements. Literature analysis reveals that, early studies primarily used demographic and clinical variables, while recent efforts integrate genetic, lifestyle, and environmental predictors. Additionally, literature analysis highlights advances in integrating real-world datasets, emerging trends like federated learning, and explainability tools such as SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations). CONCLUSION: Future work should address gaps in generalizability, interdisciplinary T2DM prediction research, and psychosocial integration, while also focusing on clinically actionable solutions and real-world applicability to combat the growing diabetes epidemic effectively.