Effectiveness of Personalized Nutrition on Management Diabetes Mellitus Type 2 and Prediabetes in Adults: A Systematic Review.

Abstract

Background: Diabetes mellitus type 2 and prediabetes are diet-related diseases with varied individual responses to routine dietary interventions. Personalized nutrition, a novel approach tailored to individual variability in response to nutrients, may offer improved outcomes.

Purpose: This systematic review analyzed the effectiveness of personalized nutrition compared to control diet for managing diabetes mellitus type 2 and prediabetes.

Methods: A comprehensive search was conducted in Medline, PubMed, and Cochrane CENTRAL for randomized controlled trials (RCTs) published in English up to March 31, 2024. Studies involving humans were screened independently by two reviewers, who also extracted data and assessed study quality using the Risk of Bias 2 tool. The SWiM (Synthesis Without Meta-Analysis) approach was used to summarize effect estimates and combine p-values.

Results: Eight studies, including five RCTs, met the inclusion criteria. Two studies had high risk of bias and another six had some concern bias. Personalized nutrition significantly reduced HbA1c (median mean difference: -0.925%, p < 0.01, 4 studies), though the effect was minimal in studies with some concern of bias (-0.035%). Fasting glucose showed no significant change (p = 0.12, 2 studies) in prediabetics, while PPGR improved significantly (-14.85 mg/dLxh, p < 0.01, 2 studies). Energy intake did not significantly differ (p = 0.06). Personalized nutrition reduced body weight (-0.58%) compared to control only when including high-risk studies; this effect was not significant in lower-risk studies (p = 0.06). Personalized nutrition also significantly reduced carbohydrate intake (-10.8% of energy, p = 0.02) compared to control diet. It also improved gut microbiome diversity and richness from baseline in prediabetics.

Conclusion: Personalized nutrition shows promise in improving HbA1c, PPGR, and reducing carbohydrate intake, with potential effects on body weight, in adults with diabetes mellitus type 2 or prediabetes. Effects on fasting glucose and energy intake remain unclear.