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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Diabetes".

Deadline for manuscript submissions: closed (15 April 2025) | Viewed by 27510

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Special Issue Editors

Prof. Dr. Triantafyllos Didangelos

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Guest Editor

Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Greece
Interests: diabetic neuropathy; new technologies in diabetes; diabetes mellitus type 1; diabetes mellitus type 2; insulin treatment; nutritional supplements in DM
Special Issues, Collections and Topics in MDPI journals

Dr. Konstantinos Kantartzis

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Guest Editor

1. Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University of Tübingen, Tübingen, Germany
2. Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Centre Munich, University of Tübingen, Tübingen, Germany
Interests: prevention and therapy of type 2 diabetes; role of adiposity and body fat distribution; fat accumulation in the liver (fatty liver, NAFLD) in the pathogenesis of diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Medical nutritional therapy is fundamental in preventing or managing existing diabetes and preventing or slowing its complications. The American Diabetes Association consensus report also suggests that nutrition is critical for the overall diabetes management. Nutritional supplements are central to such strategies and, in many cases, are an integral part of the antidiabetic management, constituting perhaps the most relevant part of diabetes prevention programs and a continuously integrated part of diabetes therapy. In addition, many consumers believe that dietary supplements are safer and possibly more effective than drugs to treat diabetes. However, the aggregated studies suggest little clinical evidence for using nutritional supplements (e.g., vitamins and minerals) to reduce or control diabetes. Diabetes mellitus is well known to be a significant global health issue, affecting some 500 million people or about 10% of the adult population worldwide. DM may finally lead to a cascade of complications such as diabetic nephropathy, diabetic eye diseases, and diabetic foot. This Special Issue examines the efficacy and possibility of select dietary supplements (i.e., proteins, branched-chain amino acids, creatine, vitamin D, and vitamin B12) for managing T2D and its complications. These nutritional supplements appear to show promise for individuals with T2D, but further research, especially long-term RCTs, is needed before consensus on the efficacy of these select supplements for individuals with T2D can be achieved for any intervention used in clinical practice, which can positively impact patient outcomes and reduce health care utilization. All these topics are potential objectives of our Special Issue, “Diabetes Mellitus and Nutritional Supplements”, in which we cordially invite all of you, clinicians and researchers, to submit your scientific work, either as original or review articles.

Prof. Dr. Triantafyllos Didangelos
Dr. Konstantinos Kantartzis
Guest Editors

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Keywords

vitamins
saturated fatty acids
unsaturated fatty acids
proteins
minerals
diabetes

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Published Papers (9 papers)

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23 pages, 4684 KiB

Open AccessArticle

Omega-3 Fatty Acids Weaken Lymphocyte Inflammatory Features and Improve Glycemic Control in Nonobese Diabetic Goto-Kakizaki Rats

by Tiago Bertola Lobato, Elvirah Samantha de Sousa Santos, Patrícia Nancy Iser-Bem, Henrique de Souza Falcão, Gabriela Mandú Gimenes, Janaina Ribeiro Barbosa Pauferro, Glayce Tavares Rodrigues, Ilana Souza Correa, Ana Carolina Gomes Pereira, Maria Elizabeth Pereira Passos, João Carlos de Oliveira Borges, Amara Cassandra dos Anjos Alves, Camila Soares dos Santos, Maria Janaina Leite de Araújo, Vinícius Leonardo Sousa Diniz, Adriana Cristina Levada-Pires, Tânia Cristina Pithon-Curi, Laureane Nunes Masi, Rui Curi, Sandro Massao Hirabara and Renata Gorjão Show full author list Hide full author list

Nutrients 2024, 16(23), 4106; https://doi.org/10.3390/nu16234106 - 28 Nov 2024

Cited by 1 | Viewed by 3853

Abstract

Background/Objectives: Goto-Kakizaki (GK) rats exhibit insulin resistance and type 2 diabetes mellitus (T2DM) without obesity. This study explored the effects of ω-3 fatty acid supplementation on T lymphocyte polarization in Wistar (WT) and GK rats. Methods: They were administered ω-3 fatty acid-rich fish oil (FO) containing eicosapentaenoic (540 mg/g) and docosahexaenoic acids (100 mg/g) by oral gavage at 2 g/kg, thrice a week for 8 weeks. The control groups (WT CT and GK CT) received the same volume of water. The following groups were investigated: GK CT, n = 14; GK ω-3, n = 15; Wistar CT, n = 15; and Wistar ω-3, n = 11. Glucose and insulin tolerance tests (GTT and ITT) were performed. Fasting plasma insulinemia and glycemia were measured. After euthanasia, the lymphocytes were extracted from the mesenteric lymph nodes. Results: The results showed that GK rats supplemented with FO had significantly improved glucose tolerance and insulin sensitivity (kITT). It also promoted greater polarization of lymphocytes toward T regulatory (Treg) features and a reduction in Th1 and Th17 profiles. Additionally, the GK ω-3 group exhibited lower cell proliferation, decreased pro-inflammatory cytokines, and increased IL-10 levels compared to the GK control. Conclusions: In conclusion, FO supplementation benefited GK rats by improving glucose intolerance, suppressing insulin resistance, and modulating lymphocytes toward Treg polarization. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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15 pages, 2710 KiB

Open AccessArticle

Trends and Motivations in Dietary Supplement Use Among People with Diabetes: A Population-Based Analysis Using National Health and Nutrition Examination Survey Data from the 2009–2020 Period

by Yan Jiang, Xuhui Chen, Zhen Cai, Ying Yao and Shuaiwen Huang

Nutrients 2024, 16(23), 4021; https://doi.org/10.3390/nu16234021 - 24 Nov 2024

Viewed by 1787

Abstract

Objectives: Dietary supplements have gained attention among people with diabetes as an alternative and complementary treatment, yet there is a limited understanding of supplement use and the motivations behind it. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) from the 2009–2020 period were analyzed, including data on 5784 people with diabetes aged 20 years or older. Dietary supplement use was self-reported. Trends in supplement use were examined across three periods: 2009–2012, 2013–2016, and 2017–2020. Statistical analyses were conducted while considering NHANES’s complex survey design to provide nationally representative estimates for the general noninstitutionalized population of the United States. Results: A total of 61.72% of individuals reported using dietary supplements with a notable increase over time. Supplement users were generally older, more likely to be female, better educated, and had superior blood glucose control with lower smoking rates compared to non-users. Common supplements included multivitamins, multimineral supplements, vitamin D, calcium, zinc, vitamin C, and fish oil. Only 44.58% of individuals used dietary supplements based on medical advice, with the rest opting for self-directed usage. The primary specific health reasons for supplement use were to improve bone health and heart health and enhance the immune system. Conclusions: Dietary supplement use is prevalent among people with diabetes, and most diabetic supplement use is self-directed, which reflects a growing trend toward complementary therapies. Healthcare providers are encouraged to inquire about patients’ use of supplements and offer appropriate guidance as an integral component of comprehensive diabetes management. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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16 pages, 1820 KiB

Open AccessArticle

Effect of a Triterpenoid-Rich Olive Oil on Chronic Kidney Disease in an Experimental Model of Diabetes Mellitus

by José Pedro De La Cruz, Laura Osuna-Esteban, María Dolores Rodríguez-Pérez, Laura Ortega-Hombrados, Ana María Sánchez-Tévar, Esther Martín-Aurioles, María África Fernández-Prior, Sergio Pérez-Burillo, Juan Antonio Espejo-Calvo and José Antonio González-Correa

Nutrients 2024, 16(16), 2794; https://doi.org/10.3390/nu16162794 - 21 Aug 2024

Viewed by 1883

Abstract

The aim of this study was to assess the effect of triterpenoids on the development of diabetic nephropathy in an experimental model of diabetes mellitus. For this purpose, a destoned and dehydrated olive oil (DDOO) was used, comparing its effects to a destoned olive oil (DOO). DDOO had a higher triterpenoid content than DOO but an equal content of alcoholic polyphenols. Four study groups (n = 10 animals/group) were formed: healthy rats, diabetic control rats (DRs), and DRs treated orally with 0.5 mL/kg/day of DOO or DDOO for two months. DRs showed impaired renal function (proteinuria, increased serum creatinine, decreased renal creatinine clearance) and morphology (glomerular volume and glomerulosclerosis). These alterations correlated with increased systemic and renal tissue oxidative stress and decreased prostacyclin production. DDOO administration significantly reduced all variables of renal damage, as well as systemic and renal oxidative stress, to a greater extent than the effect produced by DOO. In conclusion, triterpenoid-rich olive oil may prevent kidney damage in experimental diabetes mellitus. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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12 pages, 409 KiB

Open AccessArticle

Curcumin Reduces Depression in Obese Patients with Type 2 Diabetes: A Randomized Controlled Trial

by Metha Yaikwawong, Laddawan Jansarikit, Siwanon Jirawatnotai and Somlak Chuengsamarn

Nutrients 2024, 16(15), 2414; https://doi.org/10.3390/nu16152414 - 25 Jul 2024

Cited by 2 | Viewed by 3794

Abstract

Type 2 diabetes and depression co-occur in a bidirectional manner. Curcumin supplements exhibit antidepressant effects that may mitigate depression by modulating neurotransmitters and reducing inflammatory and oxidative stress pathways. This study aimed to evaluate the efficacy of curcumin in improving depression severity in obese type 2 diabetes patients. The study employed a randomized, double-blind, placebo-controlled trial design with 227 participants. The primary end-point was depression severity assessed using the Patient Health Questionnaire-9. Biomarkers were measured at baseline and at 3-, 6-, 9-, and 12-month intervals. The biomarkers assessed were serotonin levels, pro-inflammatory cytokines (interleukin-1 beta, interleukin-6, tumor necrosis factor-alpha), antioxidant activities (total antioxidant status, glutathione peroxidase, and superoxide dismutase), and malondialdehyde. After 12 months, the curcumin group exhibited significantly improved depression severity (p = 0.000001). The curcumin group had higher levels of serotonin (p < 0.0001) but lower levels of interleukin-1 beta, interleukin-6, and tumor necrosis factor-alpha (p < 0.001 for all) than the placebo group. Total antioxidant status, glutathione peroxidase activity, and superoxide dismutase activity were elevated in the curcumin group, whereas malondialdehyde levels were greater in the placebo group (p < 0.001 for all). These findings suggest curcumin may have antidepressant effects on obese type 2 diabetes patients. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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14 pages, 359 KiB

Open AccessArticle

Effect of Crocus sativus Extract Supplementation in the Metabolic Control of People with Diabetes Mellitus Type 1: A Double-Blind Randomized Placebo-Controlled Trial

by Parthena Giannoulaki, Evangelia Kotzakioulafi, Alexandros Nakas, Zisis Kontoninas, Eleni Karlafti, Polykarpos Evripidou, Konstantinos Kantartzis, Christos Savopoulos, Michail Chourdakis and Triantafyllos Didangelos

Nutrients 2024, 16(13), 2089; https://doi.org/10.3390/nu16132089 - 29 Jun 2024

Cited by 3 | Viewed by 3334

Abstract

Introduction–Background: Data from experimental trials show that Crocus sativus L. (saffron) is considered to improve glycemia, lipid profile, and blood pressure and reduce oxidative stress. So far, clinical trials have been conducted in individuals with metabolic syndrome and Diabetes Mellitus type 2 (DMT-2). The purpose of this study is to assess the effectiveness of saffron in individuals with Diabetes Mellitus type 1 (DMT-1). Patients–Methods: 61 individuals with DMT-1, mean age 48 years old (48.3 ± 14.6), 26 females (42.6%) were randomized to receive a new oral supplement in sachets containing probiotics, prebiotics, magnesium, and Crocus sativus L. extract or placebo containing probiotics, prebiotics and magnesium daily for 6 months. Glycemic control was assessed with a continuous glucose monitoring system and laboratory measurement of HbA1c and lipid profile was also examined. Blood pressure at baseline and end of intervention was also measured. Individuals were either on a continuous subcutaneous insulin infusion with an insulin pump or in multiple daily injection regimens. Diabetes distress and satiety were assessed through a questionnaire and body composition was assessed with bioelectrical impedance. Results: At the end of the intervention, the two groups differed significantly only in serum triglycerides (p = 0.049). After 6 months of treatment, a significant reduction in the active group was observed in glycated hemoglobin (p = 0.046) and serum triglycerides (p = 0.021) compared to baseline. The other primary endpoints (glycemic control, lipid profile, blood pressure) did not differ within the groups from baseline to end of intervention, and there was no significant difference between the two groups. Diabetes distress score improved significantly only in the active group (p = 0.044), suggesting an overall improvement in diabetes disease burden in these individuals but that was not significant enough between the two groups. Conclusions: A probiotic supplement with saffron extract improves serum triglycerides in well-controlled people with DMT-1 and may potentially be a valuable adjunct for enhancing glycemic control. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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15 pages, 965 KiB

Open AccessArticle

Joint B Vitamin Intake and Type 2 Diabetes Risk: The Mediating Role of Inflammation in a Prospective Shanghai Cohort

by Yang Zhu, Tao Ying, Mingjing Xu, Qing Chen, Min Wu, Yuwei Liu and Gengsheng He

Nutrients 2024, 16(12), 1901; https://doi.org/10.3390/nu16121901 - 16 Jun 2024

Cited by 4 | Viewed by 2628

Abstract

Background and Aims: Type 2 diabetes (T2D) is a global and complex public health challenge, and dietary management is acknowledged as critical in its prevention. Recent studies have highlighted the involvement of micronutrients in T2D pathophysiology; our study aims to assess the association between B vitamin intake and T2D risks and the mediating role of inflammation. Methods: In a prospective cohort design, data on B vitamins intake, including thiamine (B1), riboflavin (B2), niacin (B3), pyridoxine (B6), folate (B9), and cobalamin (B12), was obtained using a validated food frequency questionnaire (FFQ), and blood inflammatory biomarkers were analyzed according to standard protocol in the local hospitals at baseline from 44,960 adults in the Shanghai Suburban Adult Cohort and Biobank (SSACB). Incident T2D cases were identified according to a physician’s diagnosis or medication records from the electronic medical information system. We employed logistic and weighted quantile sum regression models to explore the associations of single and combined levels of B vitamins with T2D and mediation analyses to investigate the effects of inflammation. Results: Negative correlations between B vitamins and T2D were observed in the single-exposure models, except for B3. The analyses of joint exposure (B1, B2, B6, B9, and B12) also showed an inverse association (OR 0.80, 95% CI 0.71 to 0.88), with vitamin B6 accounting for 45.58% of the effects. Further mediation analysis indicated a mediating inflammatory impact, accounting for 6.72% of the relationship. Conclusions: Dietary intake of B vitamins (B1, B2, B6, B9, B12) was associated with a reduced T2D risk partially mediated by inflammation in Shanghai residents. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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Review

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47 pages, 4285 KiB

Open AccessReview

Protective Role of Dietary Polyphenols in the Management and Treatment of Type 2 Diabetes Mellitus

by Monika Martiniakova, Anna Sarocka, Noemi Penzes, Roman Biro, Veronika Kovacova, Vladimira Mondockova, Aneta Sevcikova, Sona Ciernikova and Radoslav Omelka

Nutrients 2025, 17(2), 275; https://doi.org/10.3390/nu17020275 - 13 Jan 2025

Cited by 4 | Viewed by 2435

Abstract

Type 2 diabetes mellitus (T2DM), a serious metabolic disorder, is a worldwide health problem due to the alarming rise in prevalence and elevated morbidity and mortality. Chronic hyperglycemia, insulin resistance, and ineffective insulin effect and secretion are hallmarks of T2DM, leading to many serious secondary complications. These include, in particular, cardiovascular disorders, diabetic neuropathy, nephropathy and retinopathy, diabetic foot, osteoporosis, liver damage, susceptibility to infections and some cancers. Polyphenols such as flavonoids, phenolic acids, stilbenes, tannins, and lignans constitute an extensive and heterogeneous group of phytochemicals in fresh fruits, vegetables and their products. Various in vitro studies, animal model studies and available clinical trials revealed that flavonoids (e.g., quercetin, kaempferol, rutin, epicatechin, genistein, daidzein, anthocyanins), phenolic acids (e.g., chlorogenic, caffeic, ellagic, gallic acids, curcumin), stilbenes (e.g., resveratrol), tannins (e.g., procyanidin B2, seaweed phlorotannins), lignans (e.g., pinoresinol) have the ability to lower hyperglycemia, enhance insulin sensitivity and improve insulin secretion, scavenge reactive oxygen species, reduce chronic inflammation, modulate gut microbiota, and alleviate secondary complications of T2DM. The interaction between polyphenols and conventional antidiabetic drugs offers a promising strategy in the management and treatment of T2DM, especially in advanced disease stages. Synergistic effects of polyphenols with antidiabetic drugs have been documented, but also antagonistic interactions that may impair drug efficacy. Therefore, additional research is required to clarify mutual interactions in order to use the knowledge in clinical applications. Nevertheless, dietary polyphenols can be successfully applied as part of supportive treatment for T2DM, as they reduce both obvious clinical symptoms and secondary complications. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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26 pages, 738 KiB

Open AccessEditor’s ChoiceReview

Vitamin D Supplementation: Shedding Light on the Role of the Sunshine Vitamin in the Prevention and Management of Type 2 Diabetes and Its Complications

by Dimitra Vasdeki, Georgios Tsamos, Evangelos Dimakakos, Vasileios Patriarcheas, Theocharis Koufakis, Kalliopi Kotsa, Armand Cholewka and Agata Stanek

Nutrients 2024, 16(21), 3651; https://doi.org/10.3390/nu16213651 - 26 Oct 2024

Cited by 7 | Viewed by 6495

Abstract

As the incidence of type 2 diabetes mellitus (T2DM) continues to increase globally, researchers are keen to investigate various interventions to mitigate its impact. Among these, vitamin D supplementation has attracted significant attention due to its influence on insulin secretion from the pancreas and insulin receptors in body cells. A substantial body of evidence indicates that vitamin D supplementation can reduce low-grade inflammation, a critical factor in developing insulin resistance. In addition, vitamin D aids in sustaining low resting concentrations of reactive oxygen species and free radicals, normalizes Ca²⁺ signaling, diminishes the expression of cytokines that are pro-inflammatory, and enhances the production of cytokines that are anti-inflammatory. This review discusses the effects of vitamin D on the glycemic control of individuals with T2DM and evaluates the impact of vitamin D supplementation on glycemic markers in this population. The investigation employs a comprehensive analysis of the existing literature with a special focus on recent studies published in the past decade. Based on the findings in the literature, it can be concluded that vitamin D supplementation alongside anti-diabetic medications may enhance glycemic control and potentially reduce the risk of diabetic complications. The evidence supports the notion that vitamin D supplementation can be a valuable addition to pharmacological agents for the management of T2DM, potentially enhancing glycemic control and overall health outcomes in affected individuals. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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8 pages, 976 KiB

Open AccessBrief Report

Before or Concomitant Drinking Greenleaf Juice with Rice Reduces Postprandial Blood Glucose Levels in Healthy Young Women

by Nobuko Sera, Fuka Taguchi, Isaki Hanamura and Ryoko Hongo

Nutrients 2024, 16(19), 3226; https://doi.org/10.3390/nu16193226 - 24 Sep 2024

Viewed by 1091

Abstract

The purpose of this study was to examine how green leaf juice drinking affect the postprandial blood glucose. Postprandial hyperglycemia causes vascular endothelial damage and chronic inflammation, promoting atherosclerosis, regardless of the presence of diabetes. Some ingredients in greenleaf juice have been reported to suppress blood glucose levels; however, the effect of greenleaf juice on reducing blood glucose levels in healthy individuals is unclear. We observed changes in postprandial blood glucose levels in 13 healthy young women who drank greenleaf juice before or concomitantly with rice. Compared to water, greenleaf juice consumption reduced blood glucose levels at 90 and 120 min after rice consumption, with no difference regardless of the time of greenleaf juice consumption. Greenleaf juice may be one of the most convenient and cost-effective methods for reducing postprandial blood glucose in healthy people. Full article

(This article belongs to the Special Issue Diabetes Mellitus and Nutritional Supplements)

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