Review on developing nutritional intervention approaches as therapy for diabetes mellitus 1. Introduction 2. Literature review3. Metabolic vulnerabilities of diabetes4. General pathways nutrient metabolism5. Tissue specific metabolism6. Systemic effects of dietary therapies7. Other dietary intervention

1. 05-01-2024

2. Dr. M.R.Kumbhare
Professor and HOD
Department of Pharmaceutical
Chemistry
S.M.B.T. College of Pharmacy
Nashik-422403
A Presentation
On
Review on developing nutritional intervention approaches as
therapy for diabetes mellitus
1
05-01-2024

3. 2
CONTENTS
1. Introduction
2. Literature review
3. Metabolic vulnerabilities of diabetes
4. General pathways nutrient metabolism
5. Tissue specific metabolism
6. Systemic effects of dietary therapies
7. Other dietary intervention
8. Conclusion
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4. Low caloric diet
Low fat diet
Mediterranean diet
Low carbohydrate diet
Targeted organs Diets
Liver
pancrea
s
GIT
Human body
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Graphical abstract

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Introduction
 Healthy diet is important for life, as stated
by the old saying you are what you eat.
 Boosts immunity
 Lowers risk of heart disease, type 2 diabetes,
and some cancers.
 Supports healthy pregnancies and
breastfeeding.
 Helps achieve and maintain a healthy weight
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Diabetes mellitus is a persistent disease. defined by
disturbances in the metabolism of protein, fat, and
carbohydrates.
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 General pathways nutrient metabolism.
• Excess lipid accumulation leads to insulin resistance
• Accumulated lipid metabolites like diacylglycerol and
other long chain fatty acid interfere with insulin stimulation
• Obese person ,diabetic patients have impairment of fat
metabolism
• Exercise ,diet promotes smooth proper functioning of
enzymes like glucokinase and pyruvate kinase
Metabolic vulnerabilities of diabetes
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Tissue specific metabolism
• Fat accumulation in organs such the heart, liver, and pancreas are a
key indicator and screening tool for initiating preventive
intervention.
• Too much glucose and VLDL is exported by the liver, muscle is
unable to metabolise fat or glucose.
• pancreatic first-phase insulin response is absent.
Heart Pancreas Gastrointestinal track
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Diets currently considered useful for managing
diabetes worldwide
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10. Low carbohydrate
diet
Mediterranean diet
Low caloric diet
Low fat diet
Diabetes and
Associated
Complications
Β cell
Protection Lower
glucose levels
Antioxidant
regulating
neurogranin
associated calcium
signaling β cell
production
Improved
insulin
sensitivity
Improved
beta cell
functioning
Mechanism of diets in management of diabetes
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Other dietary interventions
 Traditional Indian food
Millet Barley Bitter gourd
Amla 10

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 Diet treatment to control glucose and
gestational weight gain
 Gestational diabetes is hyperglycaemia with blood glucose values above
normal but below those diagnostic of diabetes. Gestational diabetes occurs
during pregnancy
 Women with gestational diabetes are at an increased risk of complications
during pregnancy and at delivery.
 One small limited study found that it's safe to
In pregnant women with diabetes, 40% of the diet should consist of
carbohydrates
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13. Vitamins, minerals, and antioxidants
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• Optimum vitamin, mineral, and antioxidant intake should be maintained for
general health and cardiovascular protection.
• Many fresh fruits and vegetables are naturally rich in antioxidants
(tocopherols, carotenoids, vitamin C, and flavonoids) and are strongly
recommended for young people with diabetes.
• Supplements of vitamins, minerals, or trace elements are not usually
recommended unless nutritional assessment confirms a specific deficiency.
• Supplements such as vitamin D for young children are recommended in some
countries following the national guidelines for healthy children.
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For example :
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conclusion
The dietary goals covered here, along with other lifestyle changes,
If consistently applied, can help to improve metabolic profiles and
ultimately help prevent long term complications associated with
diabetes.
Motivating the patients with diabetes to make changes by working
with diabetes management team to implement and individualized
program may help to elicit positive outcomes.
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References:
• IDF Diabetes Atlas 2021 | IDF Diabetes Atlas [Internet]. [cited 2022 Nov 30].
• Kelley DE, Goodpaster B, Wing RR, Simoneau JA. Skeletal muscle fatty acid metabolism in
association with insulin resistance, obesity, and weight loss. Am J Physiol 277, E1130-E1141
[Internet]. The American journal of physiology.
• Baena-Díez JM, Peñafiel J, Subirana I, Ramos R, Elosua R, Marín-Ibañez A, et al. Risk of
Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis. Diabetes
Care [Internet]. 2016 Nov 1,39(11):1987–95.
• Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, Peters C, Barnes AC, Aribisala BS, et al.
Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content
but Is Dependent upon Capacity for β Cell Recovery. Cell Metab [Internet]. 2018 Oct 2
• White MG, Shaw JAM, Taylor R. Type 2 Diabetes: The Pathologic Basis of Reversible β-
Cell Dysfunction. Diabetes Care [Internet]. 2016 Nov 1 39(11):2080–8.
• Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz
CM, et al. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific
Statement From the American Heart Association. Circulation [Internet]. 2021 Dec
7;144(23):e472–87. 17