- Visibility 248 Views
- Downloads 263 Downloads
- Permissions
- DOI 10.18231/j.ijnmhs.2025.011
-
CrossMark
The role of nutritional interventions in the prevention and management of type 2 diabetes mellitus: Mechanistic insights and clinical implications
- Author Details:
-
Pankaj Ramdas Khuspe *
-
Devata Haridas Shinde
-
Dipali Vikas Mane
-
Sitaram Vasant Kale
-
Abhijeet Survase
Pankaj Ramdas Khuspe *
Dipali Vikas Mane
Type 2 diabetes mellitus (T2DM), a prevalent chronic metabolic disease, is characterized by progressive β-cell dysfunction, insulin resistance, and impaired glucose homeostasis. Nutritional management plays a pivotal role in both the prevention and treatment of T2DM by influencing glycemic control, lipid profiles, and inflammatory markers. Recent evidence demonstrates that the quality of macronutrients, in addition to their quantity, significantly impacts metabolic outcomes in individuals with diabetes. Diets rich in plant-based proteins, unsaturated fatty acids, and low-glycemic index carbohydrates have been associated with improved postprandial glucose regulation and enhanced insulin sensitivity. The specific micronutrients such as vitamin D, magnesium, and chromium have shown beneficial effects on glucose uptake and insulin signaling pathways. Structured dietary patterns, including the DASH and Mediterranean diets, have consistently yielded positive clinical outcomes, such as glycemic stability and reduced diabetes-related complications. Mechanistically, these dietary interventions influence critical metabolic processes, including lipid oxidation, mitochondrial function, and enzymatic activity related to glucose transport. The increased intake of dietary fiber is linked to improved gut microbiota composition and elevated production of short-chain fatty acids, which exert insulin-sensitizing and anti-inflammatory effects. The importance of personalized nutrition tailored to individual metabolic profiles, cultural factors, and genetic predispositions is increasingly recognized in achieving optimal therapeutic outcomes. This review underscores the multifaceted role of diet in diabetes management and highlights the need to integrate customized nutritional strategies into routine clinical practice for sustainable metabolic control and enhanced quality of life in patients with T2DM.
Keywords: Nutritional therapy, Glycemic control, Type 2 diabetes, Insulin resistance, Metabolic pathways
References
- Kumar A, Gangwar R, Zargar AA, Kumar R, Sharma A. Prevalence of Diabetes in India: A Review of IDF Diabetes Atlas 10th Edition. Curr. Diabetes Rev. 2024; 20(1): e130423215752.
- Magliano DJ, Boyko EJ. IDF Diabetes Atlas 10th Edition Scientific Committee. IDF Diabetes Atlas [Internet], 10th ed; International Khuspe et al/ IP Journal of Nutrition, Metabolism and Health Science 2025;8(2):46–53 53 Diabetes Federation: Brussels, 2021. Available from: https://pubmed.ncbi.nlm.nih.gov/35914061/.
- Almutairi OM, Alhomaid TA, Alshuaibi AM, Alahmad RMA, Al Mardhamah NH, Alamri T. The influence of eating habits on type 2 diabetes in Saudi Arabia: A systematic review. Cureus. 2023;15(7):e42638.
- Almarshad MI, Algonaiman R, Alharbi HF, Almujaydil MS, Barakat H. Relationship between ultra-processed food consumption and risk of diabetes mellitus: A mini-review. Nutrients.2022;14(12):2366.
- Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A Meta-Analysis. Diabetes Care. 2010;33 (11): 2477–83.
- Bird SR, Hawley JA. Update on the Effects of Physical Activity on Insulin Sensitivity in Humans. BMJ Open Sport Exerc Med. 2017; 2(1): e000143.
- Reynolds A, Mitri J, Feingold KR, Ahmed SF, Anawalt B, Blackman MR. Dietary Advice for Individuals with Diabetes.In Endotext [Internet]. Available from: https://pubmed.ncbi.nlm.nih.gov/25905243/.
- Caricilli AM, Saad MJ. The Role of Gut Microbiota on Insulin Resistance. Nutrients.2013;5(3):829–51.
- Dludla PV, Mabhida SE, Ziqubu K, Nkambule BB, Mazibuko-Mbeje SE, Hanser S, et al. Pancreatic β-Cell Dysfunction in Type 2 Diabetes: Implications of Inflammation and Oxidative Stress. World J. Diabetes.2023;14(3):130–46.
- Freeman AM, Acevedo LA, Pennings N. Insulin Resistance. In StatPearls [Internet]; StatPearls Publishing: Treasure Island (FL), Updated 2023 Aug 17 . Available from: https://www.ncbi.nlm.nih.gov/books/NBK507839/.
- Szablewski, L. Changes in Cells Associated with Insulin Resistance. Int J Mol Sci. 2024; 25(4): 2397.
- Caturano A, D'Angelo M, Mormone A, Russo V, Mollica MP, Salvatore T, et al. Oxidative Stress in Type 2 Diabetes: Impacts from Pathogenesis to Lifestyle Modifications. Curr Issues Mol Biol. 2023;45(8):6651–66.
- Masenga SK, Kabwe LS, Chakulya M, Kirabo A. Mechanisms of Oxidative Stress in Metabolic Syndrome. Int J Mol Sci. 2023; 24(9):7898.
- Minari TP, Tácito LHB, Yugar LBT, Ferreira-Melo SE, Manzano CF, Pires AC, et al. Nutritional Strategies for the Management of Type 2 Diabetes Mellitus: A Narrative Review. Nutrients. 2023;15(24):
- Vlachos D, Malisova S, Lindberg FA, Karaniki G. Glycemic Index (GI) or Glycemic Load (GL) and Dietary Interventions for Optimizing Postprandial Hyperglycemia in Patients with T2 Diabetes: A Review. Nutrients. 2020;12(6):1561.
- Sacks FM, Carey VJ, Anderson CAM, Miller ER, Copeland T, Charleston J, et al. Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity: The OmniCarb Randomized Clinical Trial. JAMA. 2014: 312 (23): 2531–41.
- Rietman A, Schwarz J, Tomé, D, Kok FJ, Mensink M. High Dietary Protein Intake, Reducing or Eliciting Insulin Resistance? Eur J Clin Nutr. 2014; 68(9): 973–9.
- Mensink M. Dietary Protein, Amino Acids and Type 2 Diabetes Mellitus: A Short Review. Front. Nutr. 2024;11:1445981.
- Sivri D, Akdevelioğlu Y. Effect of Fatty Acids on Glucose Metabolism and Type 2 Diabetes. Nutr. Rev. 2025;83(5):897–907.
- Jia MJ, Chen L. Effect of Trace Elements and Nutrients on Diabetes and Its Complications: A Mendelian Randomization Study. Front Nutr. 2024;11:1439217.
- Dastgerdi AH; Rad MG, Soltani N. The Therapeutic Effects of Magnesium in Insulin Secretion and Insulin Resistance. Adv Biomed Res. 2022;11: 54.
- Dubey P, Thakur V, Chattopadhyay M. Role of Minerals and Trace Elements in Diabetes and Insulin Resistance. Nutrients 2020;12(6):1864.
- Germanos M, Gao A, Taper M, Yau B, Kebede MA. Inside the Insulin Secretory Granule. Metabolites. 2021;11(8):515.
- Ferdowsi PV, Ahuja KDK, Beckett JM, Myers S. Capsaicin and Zinc Signalling Pathways as Promising Targets for Managing Insulin Resistance and Type 2 Diabetes. Molecules. 2023;28(6):2861.
- Bikle DD. Vitamin D: Production, Metabolism and Mechanisms of Action. In Endotext [Internet]; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278935/.
- González P, Lozano P, Ros G, Solano F. Hyperglycemia and Oxidative Stress: An Integral, Updated and Critical Overview of Their Metabolic Interconnections. Int J Mol Sci. 2023, 24 (11), 9352.
- Sami W, Ansari T, Butt NS, Hamid MRA. Effect of Diet on Type 2 Diabetes Mellitus: A Review. Int J Health Sci. (Qassim). 2017;11(2): 65–71.
- Toi PL, Anothaisintawee T, Chaikledkaew U, Briones JR, Reutrakul S, Thakkinstian A. Preventive Role of Diet Interventions and Dietary Factors in Type 2 Diabetes Mellitus: An Umbrella Review. Nutrients.2020;12(9):2722.
- Tosti V, Bertozzi B, Fontana L. Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. J Gerontol A Biol Sci Med Sci. 2018; 73(3): 318–26.
- Challa HJ, Ameer MA, Uppaluri KR. DASH Diet to Stop Hypertension. In StatPearls [Internet]; StatPearls Publishing: Treasure Island (FL), 2025. Updated 2023 Jan 23. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482514/.
- García-Hermoso A, Esteban-Cornejo I, Olloquequi J, Ramírez-Vélez R. Cardiorespiratory Fitness and Muscular Strength as Mediators of the Influence of Fatness on Academic Achievement. J. Pediatr. 2017; 187: 127–33.e3.
- Jenkins DJA, Kendall CWC, McKeown-Eyssen G, Josse RG, Silverberg J, Booth GL, et al. Effect of a Low–Glycemic Index or a High–Cereal Fiber Diet on Type 2 Diabetes: A Randomized Trial. JAMA. 2008; 300 (23): 2742–53.
- AlEssa HB, Bhupathiraju SN, Malik VS, Wedick NM, Campos H, Rosner B, et al. Carbohydrate Quality and Quantity and Risk of Type 2 Diabetes in US Women. Am J Clin Nutr. 2021;114 (1): 81–90.
- Livesey G, Taylor R, Livesey HF, Liu S. Is There a Dose–Response Relation of Dietary Glycemic Load to Risk of Type 2 Diabetes? Meta-Analysis of Prospective Cohort Studies. Am J Clin Nutr. 2013;97(3):584–96.
- Wolever TMS. Relationship Between Dietary Fiber Content and Composition in Foods and the Glycemic Index. Am J Clin Nutr. 1990; 51(1): 72–5.
- Post RE, Mainous AG, King DE, Simpson KN. Dietary Fiber for the Treatment of Type 2 Diabetes Mellitus: A Meta-Analysis. J Am Board Fam Med. 2012; 25(1):16–23.
- Seidelmann SB, Claggett B, Cheng S, Henglin M, Shah A, Steffen LM, et al. Dietary Carbohydrate Intake and Mortality: A Prospective Cohort Study and Meta -Analysis. Lancet Public Health.2018;3(9):e419–e428.
- Sluijs I, Beulens JWJ, van der A DL, Spijkerman AMW, Grobbee DE, van der Schouw YT. Dietary Intake of Total, Animal, and Vegetable Protein and Risk of Type 2 Diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)–NL Study. Diabetes Care. 2010; 33(1): 43–8.
- Malik VS, Hu FB. Sugar-Sweetened Beverages and Cardiometabolic Health: An Update of the Evidence. Nutrients.2019; 11(8):1840.
- Vilsbøll T, Bain SC, Leiter LA, Lingvay I, Matthews D, Simó R, et al. Semaglutide, reduction in glycated haemoglobin and the risk of diabetic retinopathy. Diabetes Obes Metab . 2018;20(4):889–97.