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Nutrients
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Advances in Diabetology: Nutritional Aspects for Diabetic Complications
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Advances in Diabetology: Nutritional Aspects for Diabetic Complications

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

Deadline for manuscript submissions: 25 May 2026 | Viewed by 1761

Special Issue Editors

Dr. Hanako Nakajima

E-Mail Website
Guest Editor
Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Interests: metabolomics analysis; soluble dietary fiber; sarcopenia; vitamin D; type 2 diabetes; endcrinology
Dr. Yoshitaka Hashimoto

E-Mail Website
Guest Editor
Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Interests: diet; gut; metabolic syndrome; microbiota; nutrition; obesity; type 2 diabetes
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetes mellitus remains a global health challenge, and its chronic complications—such as cardiovascular disease, nephropathy, retinopathy, and neuropathy—are major contributors to morbidity and mortality. Beyond glucose management, nutrition therapy is increasingly recognized as a critical determinant of disease trajectory. We invite contributions that investigate both mechanistic insights and clinical applications of nutrition in preventing or managing diabetic complications.

This Special Issue of Nutrients aims to present a comprehensive overview exploring the interactions between nutritional factors and the pathophysiology of diabetes-related complications.

Dr. Hanako Nakajima
Dr. Yoshitaka Hashimoto
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • complications
  • diabetes
  • dietary therapy
  • nutrition
  • glucose management
  • hypoglycemia
  • retinopathy
  • neuropathy
  • nephropathy/DKD
  • obesity
  • sarcopenia
  • frail
  • malignancy
  • fatty Liver/MAFLD
  • Alb
  • transthyretine
  • ketone

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Published Papers (3 papers)

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Research

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18 pages, 1760 KB  
Article
The Prognostic Nutritional Index and Glycemic Status Synergistically Predict Early Renal Function Decline in Type 2 Diabetes: A Community-Based Cohort Study
by Yuting Yu, Jianguo Yu, Jing Li, Jiedong Xu, Yunhui Wang, Lihua Jiang, Genming Zhao and Yonggen Jiang
Nutrients 2026, 18(3), 395; https://doi.org/10.3390/nu18030395 - 25 Jan 2026
Viewed by 762
Abstract
Background/Objectives: The Prognostic Nutritional Index (PNI), which integrates serum albumin and lymphocyte count, reflects both nutritional and inflammatory status. However, its role in early renal function decline among patients with type 2 diabetes (T2D), particularly in relation to glycemic control, remains unclear. [...] Read more.
Background/Objectives: The Prognostic Nutritional Index (PNI), which integrates serum albumin and lymphocyte count, reflects both nutritional and inflammatory status. However, its role in early renal function decline among patients with type 2 diabetes (T2D), particularly in relation to glycemic control, remains unclear. This study aimed to: (1) characterize the dose–response relationship between PNI and early renal function decline in type 2 diabetes using restricted cubic splines; (2) identify whether glycemic control (HbA1c) modifies the PNI–renal decline association; and (3) evaluate the clinical utility of combining PNI and HbA1c for risk stratification. Methods: We analyzed data from 1711 community-based participants with T2D who had preserved renal function at baseline. The PNI was calculated as serum albumin (g/L) + 5 × lymphocyte count (×109/L). The primary outcome was a composite of rapid estimated glomerular filtration rate (eGFR) decline (>3 mL/min/1.73 m2 per year) or incident chronic kidney disease (CKD) stage 3. Restricted cubic spline models, multivariable regression, and Johnson–Neyman analyses were used to examine non-linearity and effect modification by glycated hemoglobin (HbA1c). Results: A consistent inverse linear association was observed between PNI and the rate of eGFR decline (P for non-linearity > 0.05). Johnson–Neyman analysis further demonstrated that the protective association of PNI was statistically significant within an HbA1c range of 7.24% to 8.71%. Stratification by clinical cut-offs revealed a significant effect modification by glycemic status. The inverse linear association between PNI and renal risk was most pronounced under hyperglycemic stress, as evidenced by the markedly elevated incidence (50.0%) among individuals with both poor glycemic control (HbA1c ≥ 8%) and low PNI (<50). Conversely, under good glycemic control (HbA1c < 8%), this inverse association was substantially attenuated, with a lower incidence observed in the low-PNI subgroup (6.7%) than in the high-PNI subgroup (15.9%). These findings indicate that the protective role of PNI is conditional upon the glycemic milieu. Conclusions: The PNI demonstrates a stable linear association with early renal function decline in T2D, with its protective effect most pronounced at suboptimal HbA1c levels. Combining PNI and HbA1c effectively identifies a high-risk subgroup characterized by synergistic risk, underscoring the need for integrated nutritional and glycemic management. Full article
(This article belongs to the Special Issue Advances in Diabetology: Nutritional Aspects for Diabetic Complications)
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12 pages, 926 KB  
Article
Association Between Muscle Quality and GNRI in Patients with Type 2 Diabetes
by Shinta Yamamoto, Yoshitaka Hashimoto, Fuyuko Takahashi, Moe Murai, Nozomi Yoshioka, Yuto Saijo, Chihiro Munekawa, Hanako Nakajima, Noriyuki Kitagawa, Takafumi Osaka, Ryosuke Sakai, Hiroshi Okada, Naoko Nakanishi, Saori Majima, Emi Ushigome, Masahide Hamaguchi and Michiaki Fukui
Nutrients 2026, 18(2), 275; https://doi.org/10.3390/nu18020275 - 15 Jan 2026
Viewed by 583
Abstract
Background: Type 2 diabetes (T2D) has been linked to impairments in skeletal muscle performance, encompassing reductions in both muscle strength and muscle quality. While malnutrition is a known modifiable factor contributing to muscle quality deterioration, its specific relationship with the Geriatric Nutritional Risk [...] Read more.
Background: Type 2 diabetes (T2D) has been linked to impairments in skeletal muscle performance, encompassing reductions in both muscle strength and muscle quality. While malnutrition is a known modifiable factor contributing to muscle quality deterioration, its specific relationship with the Geriatric Nutritional Risk Index (GNRI) in T2D remains underexplored. Using data from 743 participants in the KAMOGAWA-A cohort, this cross-sectional study evaluated the association between muscle quality and GNRI in individuals with type 2 diabetes. Methods: Muscle quality was defined as handgrip strength divided by arm lean mass. GNRI was calculated using serum albumin and body mass index. Multiple linear regression models were used to assess associations between GNRI and muscle quality. To account for BMI-related dependency in muscle quality measurements, we derived BMI-adjusted GNRI residuals and performed the same regression analysis to evaluate the stability of the observed relationship beyond BMI-induced confounding. Results: In the overall population, GNRI was inversely associated with muscle quality (β = −0.17, p < 0.001). Conversely, residual GNRI demonstrated a significant positive association with muscle quality (β = 0.13, p < 0.001), especially among men, individuals under 65 years of age, and across all BMI categories. Stratified analyses suggested that the strength and direction of associations varied by age, sex, and glycemic control status. Conclusions: The GNRI showed an inverse correlation with muscle quality, whereas residual GNRI showed a consistent positive relationship. These findings suggest that improving nutritional status may support muscle function in T2D, but BMI confounds the interpretation of GNRI in this context. Full article
(This article belongs to the Special Issue Advances in Diabetology: Nutritional Aspects for Diabetic Complications)
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Review

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17 pages, 1182 KB  
Review
Effects of Dietary Fruit and Vegetable Consumption on Prediabetes: A Systematic Review and Meta-Analysis
by Seung-Hee Hong and Yun-Jung Bae
Nutrients 2026, 18(9), 1391; https://doi.org/10.3390/nu18091391 - 28 Apr 2026
Viewed by 124
Abstract
Background/Objectives: Previous studies have reported inconsistent findings regarding the association between fruit and vegetable consumption and prediabetes. Therefore, we aimed to investigate this association using a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods: Relevant [...] Read more.
Background/Objectives: Previous studies have reported inconsistent findings regarding the association between fruit and vegetable consumption and prediabetes. Therefore, we aimed to investigate this association using a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods: Relevant studies were identified through systematic searches of PubMed, EMBASE, and the Cochrane Library through January 2026 using predefined keywords. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Results: A total of 20 observational studies were included, comprising 16 cross-sectional studies, one case–control study, and three cohort studies, with 24,660 cases of prediabetes among 182,387 participants. Higher fruit and vegetable consumption was significantly associated with a lower risk of prediabetes (OR, 0.82; 95% CI, 0.74–0.91; I2 = 91.9%). Subgroup analysis by study design showed a significant association in cross-sectional studies (OR, 0.81; 95% CI, 0.70–0.94; I2 = 91.6%; n = 16), whereas cohort studies showed no significant association (OR, 0.97; 95% CI, 0.92–1.02; I2 = 15.1%; n = 3). Subgroup analyses by sex indicated a significant inverse association among male participants (OR, 0.77; 95% CI, 0.61–0.97; I2 = 63.3%; n = 4), but not among female participants (OR, 0.97; 95% CI, 0.69–1.37; I2 = 82.1%; n = 3). Conclusions: Overall, this meta-analysis indicates that greater fruit and vegetable consumption is associated with a reduced risk of prediabetes. However, additional prospective cohort studies are required to clarify potential confounding factors and confirm this association. Full article
(This article belongs to the Special Issue Advances in Diabetology: Nutritional Aspects for Diabetic Complications)
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