Dietary Interventions for the Prevention of Type 2 Diabetes in High-Risk Groups: Current State of Evidence and Future Research Needs

Abstract

A series of large-scale randomised controlled trials have demonstrated the effectiveness of lifestyle change in preventing type 2 diabetes in people with impaired glucose tolerance. Participants in these trials consumed a low-fat diet, lost a moderate amount of weight and/or increased their physical activity. Weight loss appears to be the primary driver of type 2 diabetes risk reduction, with individual dietary components playing a minor role. The effect of weight loss via other dietary approaches, such as low-carbohydrate diets, a Mediterranean dietary pattern, intermittent fasting or very-low-energy diets, on the incidence of type 2 diabetes has not been tested. These diets—as described here—could be equally, if not more effective in preventing type 2 diabetes than the tested low-fat diet, and if so, would increase choice for patients. There is also a need to understand the effect of foods and diets on beta-cell function, as the available evidence suggests moderate weight loss, as achieved in the diabetes prevention trials, improves insulin sensitivity but not beta-cell function. Finally, prediabetes is an umbrella term for different prediabetic states, each with distinct underlying pathophysiology. The limited data available question whether moderate weight loss is effective at preventing type 2 diabetes in each of the prediabetes subtypes.

Diabetogenic effect of gluten in Wistar albino rats: a preliminary preclinical screening

“…The diet and diabetes association has received a great deal of scientific attention and effort to evaluate dietary intake precisely. Dietary interventions play a key role in the prevention of T2DM [20].…”

Stationäre Therapie des Typ-2-Diabetes

“…hohen Faseranteil verzehrten, bereits nach dieser relativ kurzen Intervention eine signifikante Verbesserung der Insulinsensitivität im euglykämischen Clamp-Versuch [27]. In den vergangenen Jahren wurde zunehmend das sogenannte Intervallfasten propagiert, das entweder eine 16-stündige Fastenperiode täglich (16:8) oder eine zweitägige Fastenperiode pro Woche (5:2) vorsieht [35]. In unseren Augen kann die Durchführung von ein bis zwei Gemüsetagen, die ebenfalls im Wesentlichen auf einer temporär begrenzten Kalorienrestriktion basiert, als probate Alternative zum klassischen Intervallfasten betrachtet werden.…”

Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence

“…The DPP went on to establish lifestyle modifications, such as dietary change, physical activity, and weight loss, as the ‘gold standard’ for the prevention of T2DM [ 9 ]. Nutritional interventions contribute to weight loss by allowing calories to be derived from healthier sources, which appears to be the primary driver to reduce diabetes risk [ 10 ]. Moreover, nutritional strategies in prediabetes are also cost-effective tools for reducing the monetary burden with regards to personal as well as public healthcare expenditures.…”