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The Diabetes Diet: Making a Healthy Eating Plan

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A Special Issue of Nutrients (ISSN 2072-6643) belonging to the section "Nutrition and Diabetes".

Deadline for manuscript submissions: closed (5 March 2026) | Viewed by 25235

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Editors

Dr. Roberta Masella

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Guest Editor

Gender-Specific Prevention and Health Unit, Centre for Gender-Specific Medicine, Istituto Superiore di Sanità, 00161 Rome, Italy
Interests: nutrition; diet; Mediterranean diet; obesity; diabetes; gender
Special Issues, Collections and Topics in MDPI journals

Dr. Massimo D'Archivio

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Guest Editor

Gender-Specific Prevention and Health Unit, Centre for Gender-Specific Medicine, Istituto Superiore di Sanità, 00161 Rome, Italy
Interests: nutrients; metabolism

Special Issue Information

Dear Colleagues,

The prevalence of diabetes is increasing worldwide, making it one of the fastest-growing international health emergencies of the 21st century. Diabetes that is not well managed can have a significant impact on morbidity and mortality, serving as a risk factor for stroke, renal dysfunction, leg amputation, cardiovascular diseases, loss of vision, and neuropathy. Strategies for managing diabetes often include regular physical activity, smoking cessation, maintaining a healthy body weight, and a healthy diet. Diet is vital to diabetes management, as it helps control blood sugar levels, reduce complications, and enhance overall health. Given the importance of nutrition in preventing and managing diabetes and its consequences, we require a deeper and more accurate understanding of how to create the best dietary plans and the mechanisms that make healthy diets effective.

The aim of this Special Issue on "The Diabetes Diet: Making a Healthy Eating Plan" is to highlight novel findings that help define optimal eating plans, considering macro/micronutrients and fibre, as well as gender differences, to manage diabetes and its clinical complications.

This Special Issue welcomes contributions to this topic, and recommended reviews, original articles, brief reports, and communications are encouraged.

Dr. Roberta Masella
Dr. Massimo D'Archivio
Guest Editors

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Keywords

diabetes
diabetes management
diet
nutrition
dietary plans
macronutrients
micronutrients
fibres
gender differences

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Published Papers (9 papers)

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Research

Jump to: Review

16 pages, 1063 KB

Open AccessArticle

Duration of Type 2 Diabetes Mellitus Alters Orosensory Detection of Sweet and Fat: Insights from a Cross-Sectional Study in a North African Population

by Inchirah Karmous, Hatem Ghouili, Rym Ben Othman, Halil İbrahim Ceylan, Luca Puce, Amira Sayed Khan, Naim Akhtar Khan, Henda Jamoussi, Helmi Ben Saad, Nicola Luigi Bragazzi and Ismail Dergaa

Nutrients 2026, 18(3), 432; https://doi.org/10.3390/nu18030432 - 28 Jan 2026

Viewed by 1233

Abstract

Background: Gustatory dysfunction represents an underrecognized complication that may influence dietary behaviors and metabolic control. Previous investigations have suggested alterations in taste in patients with diabetes, yet the relationship between disease duration and specific taste modalities remains incompletely characterized. Aim: This study aimed to (i) compare orosensory detection thresholds for lipid and sweet tastes between patients with recent type 2 diabetes mellitus (rT2DM) (duration ≤ 5 years) and chronic type 2 diabetes mellitus (cT2DM) (duration > 5 years), and (ii) determine whether diabetes duration is associated with alterations in chemosensory function in a North African population. Methods: A cross-sectional comparative pilot study was conducted at the National Institute of Nutrition and Food Technology in Tunis, Tunisia, from April to June 2021. Sixty-seven patients with type 2 diabetes mellitus (T2DM) receiving oral antidiabetic medication were recruited through systematic sampling and divided into two groups: rT2DM (n = 30, duration ≤ 5 years) and cT2DM (n = 37, duration > 5 years). Orosensory detection thresholds for lipid taste were assessed using eight ascending concentrations of linoleic acid ranging from 0.018 to 12 mmol/L. In contrast, sweet taste thresholds were evaluated using a sucrose concentration series ranging from 0.01 to 5 mmol/L. The three-alternative forced-choice method with an ascending-concentration presentation was employed for both taste modalities. Detection thresholds were defined as the lowest concentration at which participants correctly identified the taste quality. Results: Patients with cT2DM exhibited significantly elevated orosensory detection thresholds compared to those with rT2DM for both taste modalities tested. The median linoleic acid detection threshold was 6.000 mmol/L in cT2DM versus 0.058 mmol/L in rT2DM (p < 0.001), representing a 107-fold increase in detection threshold. For sweet taste, the median sucrose detection threshold was 1.0 mmol/L in cT2DM compared with 0.5 mmol/L in rT2DM (p < 0.001), indicating a 2-fold increase in the threshold. In the overall patient cohort, the duration of diabetes was positively correlated with both fat taste perception thresholds (r = 0.657, p < 0.001) and sweet taste perception thresholds (r = 0.466, p < 0.001). However, when analyses were performed by diabetes duration-based subgroups, these correlations were observed only for fat taste perception in cT2DM, with no statistically significant correlations found in rT2DM. In multivariate linear regression analyses adjusted for age, body mass index, and sex/gender, the duration of diabetes remained independently associated with fat and sweet taste perception. Conclusions: Extended T2DM duration is associated with substantial elevations in orosensory detection thresholds for both lipid and sweet tastes in a North African population. These findings suggest that disease chronicity may contribute to chemosensory impairment, potentially influencing dietary preferences and metabolic control in patients with diabetes. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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12 pages, 1564 KB

Open AccessArticle

Sex-Specific Dietary Predictors of Blood Glucose Identified Through Decision Tree Modeling in Adults

by Joanna Gautney, Christina Aguilar, Julian Chan and David Aguilar

Nutrients 2025, 17(19), 3119; https://doi.org/10.3390/nu17193119 - 30 Sep 2025

Cited by 1 | Viewed by 1415

Abstract

Background/Objectives: Diabetes mellitus is a global public health crisis, with cases projected to rise to 1.3 billion by 2050. Lifestyle interventions are crucial in preventing and managing Type 2 diabetes. This study used a machine learning approach to explore the relationship between dietary components and fasting blood glucose in a young adult population, with a focus on potential sex-specific differences. Methods: This cross-sectional study analyzed data from 288 young adults (195 females, 93 males; mean age 23 years). Participants provided two-day diet records, and their fasting capillary blood glucose was measured. Machine learning was used to predict blood glucose based on a variety of dietary variables, including fiber, macronutrient proportions, and fat types. Energy expenditure was used as a proxy for energy intake. Models were created for the overall population, males, and females. Results: In the overall population, the most important predictor of fasting blood glucose was fiber intake. For females, the most important predictor was energy expenditure, followed by fat quality (linoleic to alpha-linolenic acid ratio and saturated fat intake). For males, the most predictive factor was the percentage of calories from fat, followed by alpha-linolenic acid intake. Conclusions: The findings suggest that predictors of blood glucose differ between males and females, highlighting the need for sex-specific strategies in blood glucose management. The models emphasize the importance of increasing fiber intake, maintaining a healthy energy intake, and improving fat quality by prioritizing essential fatty acids. This approach can be used to inform personalized dietary recommendations for the prevention and management of diabetes. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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13 pages, 259 KB

Open AccessArticle

Excessive Daytime Sleepiness and Associated Cardiometabolic Factors in Latino Individuals of Mexican Ancestry at High Risk of Type 2 Diabetes: An El Banco Biobank Cross-Sectional Study

by Ludovica Verde, Dawn K. Coletta, Yann C. Klimentidis, Linsday N. Kohler, Lisa Soltani, Oscar D. Parra, Sairam Parthasarathy, Lawrence J. Mandarino and Giovanna Muscogiuri

Nutrients 2025, 17(15), 2476; https://doi.org/10.3390/nu17152476 - 29 Jul 2025

Cited by 1 | Viewed by 1456

Abstract

Background/Objectives: Latinos, particularly those of Mexican ancestry, experience high rates of type 2 diabetes and sleep disturbances, exacerbating adverse health outcomes. This study aimed to examine the prevalence of excessive daytime sleepiness and its associations with diet, cardiometabolic risk factors, and glycemic control in this population. Methods: This cross-sectional study utilized data from the El Banco por Salud biobank, including 1685 participants (aged 52.6 ± 14.5 years, BMI: 32.4 ± 7.0 kg/m²) recruited from Federally Qualified Community Health Centers. Excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale, while dietary information was obtained via the Brief Dietary Assessment Tool for Hispanics. Primary outcomes included cardiometabolic risk factors and glycated hemoglobin (HbA1c) levels. Results: Excessive daytime sleepiness (Epworth Sleepiness Scale > 10) was present in 22.0% of participants and was associated with higher BMI (p < 0.001), larger waist circumference (p = 0.002), poorer diet quality, increased dyslipidemia (p = 0.036), and elevated HbA1c (p = 0.007). Linear regression analyses confirmed that excessive daytime sleepiness was significantly associated with higher HbA1c levels, both in unadjusted (R² = 0.011; p < 0.001) and adjusted for demographic, anthropometric, and socioeconomic factors (R² = 0.107; p = 0.004) models. Conclusions: Excessive daytime sleepiness among Latinos of Mexican ancestry is associated with unhealthy dietary patterns and poor glycemic control, highlighting the need for targeted interventions addressing sleep and dietary habits in this vulnerable population. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

15 pages, 570 KB

Open AccessArticle

Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors

by María Pilar Fernández-Figares Vicioso, Pere Riutord Sbert, José Ignacio Ramírez-Manent, Ángel Arturo López-González, José Luis del Barrio Fernández and María Teófila Vicente Herrero

Nutrients 2025, 17(15), 2420; https://doi.org/10.3390/nu17152420 - 24 Jul 2025

Cited by 2 | Viewed by 2326

Abstract

Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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14 pages, 456 KB

Open AccessArticle

The Cost-Effectiveness of Increased Yogurt Intake in Type 2 Diabetes in Japan

by Ryota Wakayama, Michihiro Araki, Mieko Nakamura and Nayu Ikeda

Nutrients 2025, 17(14), 2278; https://doi.org/10.3390/nu17142278 - 9 Jul 2025

Cited by 1 | Viewed by 4539

Abstract

Background/Objectives: A healthy diet helps prevent noncommunicable diseases, and dairy is an essential part of this diet. Multiple meta-analyses have shown an inverse association between yogurt intake and type 2 diabetes (T2D). This study aimed to develop a simulation model and evaluate the medical and economic effects of increased yogurt intake on T2D. Methods: It predicted the T2D incidence rate, T2D mortality rate, and national healthcare expenditures (NHE) over 10 years using a Markov model for the Japanese population aged 40–79 years. Results: By increasing yogurt intake to 160 g/day or 80 g/day, the incidence rate of T2D decreased by 16.1% or 5.9%, the T2D-related mortality rate decreased by 1.6% or 0.6%, and the NHE was predicted to decrease by 2.4% and 0.9%, respectively. Conclusions: Increasing yogurt intake may be an effective strategy to prevent T2D and reduce NHE. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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17 pages, 22603 KB

Open AccessArticle

High-Fat Diet-Induced Diabetic Cardiomyopathy in Female Zebrafish: Cardiac Pathology and Functional Decline Mediated by Type 2 Diabetes

by Shuaiwang Huang, Zhanglin Chen, Haoming Li, Yunyi Zou, Bihan Wang, Wenjun Zhao, Lan Zheng, Zuoqiong Zhou, Xiyang Peng and Changfa Tang

Nutrients 2025, 17(13), 2209; https://doi.org/10.3390/nu17132209 - 2 Jul 2025

Cited by 8 | Viewed by 2583

Abstract

Background: Diabetic cardiomyopathy (DCM) is characterized by progressive cardiac dysfunction, metabolic dysregulation, myocardial fibrosis, and mitochondrial impairment. Existing animal models, such as streptozotocin (STZ)-induced models, suffer from high mortality and fail to replicate chronic metabolic dysregulation induced by high-fat diets (HFD), whereas HFD or HFD/STZ-combined rodent models require high maintenance costs. This study aimed to establish a zebrafish HFD-DCM model to facilitate mechanistic exploration and drug discovery. Methods: Eighty wild-type female zebrafish were divided into normal diet (N, 6% fat) and HFD (H, 24% fat) groups and fed the diet for 8 weeks. Metabolic phenotypes were evaluated using intraperitoneal glucose tolerance tests and insulin level analysis. Cardiac function was assessed by using echocardiography (ejection fraction, E peak). Structural, metabolic, and oxidative stress alterations were analyzed by histopathology (H&E, Masson, and Oil Red O staining), molecular assays (RT-qPCR, Western blotting), and mitochondrial structure/function evaluations (respiratory chain activity, transmission electron microscopy, and DHE staining). Results: HFD-fed zebrafish developed obesity, insulin resistance, and impaired glucose tolerance. Echocardiography revealed cardiac hypertrophy, reduced ejection fraction, and diastolic dysfunction. Excessive lipid accumulation, upregulated fibrosis/inflammatory markers, impaired mitochondrial respiration, elevated reactive oxygen species levels, and a disrupted redox balance were observed. Conclusions: We established a female zebrafish HFD model that recapitulates human DCM features, including hypertrophy, metabolic dysregulation, fibrosis, inflammation, and mitochondrial dysfunction. This model offers novel insights into DCM pathogenesis and serves as a valuable platform for mechanistic studies and targeted drug screening. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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13 pages, 216 KB

Open AccessArticle

SNAP Participation as a Moderator of Food and Nutrition Security and Combined Cardiometabolic Conditions: A Mixed Regression Approach

by Maha Almohamad, Ruosha Li, Natalia I. Heredia, Jayna M. Dave, Eric E. Calloway, Anjail Sharrief and Shreela V. Sharma

Nutrients 2025, 17(3), 576; https://doi.org/10.3390/nu17030576 - 5 Feb 2025

Cited by 3 | Viewed by 3557

Abstract

Objectives: To examine the relationships between food security, nutrition security, Supplemental Nutrition Assistance Program (SNAP) participation, and cardiometabolic outcomes, including hypertension, hyperlipidemia, or diabetes, among low-income U.S. individuals. Methods: A cross-sectional survey of 486 participants (April–June 2021) assessed food and nutrition security and cardiometabolic outcomes. Mixed-effects logistic regression models adjusted for covariates and included a random effect for state of residence. Moderation analyses evaluated SNAP participation’s impact. Results: Very low food security was associated with higher odds of having at least one cardiometabolic condition, such as hypertension, hyperlipidemia, or diabetes (AOR = 1.96; 95% CI: 1.04–3.69; p = 0.04). SNAP moderated this relationship (p-interaction = 0.007), with non-participants experiencing significantly higher risk. Non-SNAP participants with very low food security had 3.17 (95% CI = 1.17–8.61) times higher odds of having a cardiometabolic condition. Among SNAP participants, very low food security was not significantly associated with having a cardiometabolic condition (OR = 1.62; 95% CI = 0.64–4.13). Higher nutrition security was associated with lower odds of having at least one cardiometabolic condition (AOR = 0.59; 95% CI: 0.41–0.83; p = 0.002). Conclusions: Nutrition security and SNAP participation mitigate cardiometabolic risks, underscoring their importance in public health interventions. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

Review

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23 pages, 1753 KB

Open AccessReview

Emerging Role of Taste Receptors, Entero-Endocrine Cells in Type 2 Diabetes and Metabolic Disorders

by Kyaw Linn Su Khin, Sepideh Youssefi, Qian Yang, Amanda J. Page, Abdolrahman S. Nateri, Sally Eldeghaidy, Richard L. Young and Iskandar Idris

Nutrients 2026, 18(5), 759; https://doi.org/10.3390/nu18050759 - 26 Feb 2026

Cited by 2 | Viewed by 1882

Abstract

Type 2 diabetes (T2D) is a major global healthcare challenge and burden on the quality of life in affected individuals. While lifestyle management is the mainstay treatment for T2D, the advent of gut-incretin-based therapies with powerful effects on metabolic health, appetite and weight regulation has focussed attention on the role of the gut in the risk, progression and management of T2D. Beyond the tongue, intestinal sweet taste receptors (STRs) are increasingly being identified and functionally characterised. Growing evidence now supports a role for nutrient-activated (e.g., sugars) intestinal STRs in the release of gut hormones from enteroendocrine cells (EECs) and the control of blood glucose and body weight. However, the specific STR pathway and mechanisms linking STRs to these homeostatic controls are poorly understood, with a notable gap existing between evidence from preclinical studies and clinical validation. This review explores intestinal STR-EEC functions and the evidence on how these functions regulate glucose metabolism and energy homeostasis. We further discuss the impact of environmental and dietary factors on these signalling pathways. Full knowledge of the signalling and regulation of intestinal STR-EEC and integrated neural pathways will bridge the current knowledge gap, with a high potential to develop new novel strategies targeting STRs or EECs that preserve hedonic taste rewards and reduce cravings, as well as improve the management of individuals with metabolic diseases. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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31 pages, 2861 KB

Open AccessReview

Dietary Interventions for Adults with Type 1 Diabetes: Clinical Outcomes, Guideline Alignment, and Research Gaps—A Scoping Review

by Beata Małgorzata Sperkowska, Agnieszka Chrustek, Anna Gryn-Rynko and Anna Proszowska

Nutrients 2025, 17(21), 3349; https://doi.org/10.3390/nu17213349 - 24 Oct 2025

Cited by 4 | Viewed by 4808

Abstract

Background/Objectives: Medical nutrition therapy (MNT) is a crucial component of type 1 diabetes (T1D) management; however, the effectiveness of specific dietary approaches in adults remains unclear due to variations in study design, terminology, and reported outcomes. This scoping review summarizes evidence published between 2015 and 2025 on dietary interventions in adults with T1D, focusing on metabolic and psychosocial outcomes and adherence to international nutritional guidelines. Methods: We searched PubMed, Web of Science, Scopus, and Google Scholar, following the PRISMA-ScR recommendations, to identify observational studies, randomized clinical trials (RCTs), and guidelines involving adults (≥18 years) with T1D. Extracted data included metabolic outcomes (glycated hemoglobin A1c (HbA1c), glycemic variability (GV), insulin dose (ID), lipids, blood pressure, body weight, and others), as well as psychosocial indicators (i.e., quality of life, diabetes-related stress, and fear of hypoglycemia). Results: In total, 41 studies met the inclusion criteria, comprising 18 observational, 14 randomized, and 9 studies that evaluated psychosocial aspects. A low-carbohydrate diet (LCD) reduced HbA1c by 0.3–0.9% and total ID by approximately 15–20% without increasing the incidence of severe hypoglycemia. A low-fat vegan diet and structured carbohydrate counting (CC) programs also improved glycemic and lipid profiles. The Mediterranean diet (MedDiet) and plant-based diet mainly improved diet quality and well-being. The results showed an association between better metabolic control and lower carbohydrate (CHO) intake, as well as higher intakes of fiber and protein. In contrast, a Western diet and high intake of sweets were linked to poorer outcomes. Conclusions: Combining an LCD with education, CC, and modern diabetes technology provides the most consistent benefits for adults with type 1 diabetes (T1D adults). The MedDiet and plant-based diet support diet quality and psychosocial well-being, although current evidence remains limited, primarily due to small sample sizes and short follow-up periods. Full article

(This article belongs to the Special Issue The Diabetes Diet: Making a Healthy Eating Plan)

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