Abstract
Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases and represents a leading cause of morbidity and mortality because of its related complications. The alarming rise in T2DM prevalence worldwide poses enormous challenges in relation to its social, economic, and a clinical burden requiring appropriate preventive strategies. Currently, lifestyle modifications—including approaches to promote a moderate body weight reduction and to increase regular physical exercise—are the first crucial intervention for T2DM prevention. In the light of the difficulty in reducing body weight and in long-term maintenance of weight loss, quality changes in dietary patterns—in terms of macro and micronutrient composition—can also strongly affect the development of T2DM. This may provide a more practical and suitable preventative approach than simply implementing caloric restriction. Along this line, there is increasing evidence that wholegrain consumption in substitution of refined grains is associated with a reduction of the incidence of several non-communicable chronic diseases. The aim of the present review is to summarize the current evidence from observational and randomized controlled clinical trials on the benefits of wholegrain on T2DM prevention and treatment. Plausible mechanisms by which wholegrain could act on glucose homeostasis and T2DM prevention are also evaluated. Altogether, the totality of the available evidence supports present dietary recommendations promoting wholegrain foods for the prevention and treatment of T2DM.
Highlights
Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases with 415 million cases estimated globally in 2015; this number is expected to increase dramatically in the decades reaching 642 million by 2040 [1]
We have reviewed the evidence from observational studies, clinical trials, randomized clinical trials (RCTs), and meta-analyses published in the last fifteen years on Pubmed, which evaluated the relationship between wholegrain consumption and T2DM
With respect to randomized controlled trials (RCTs) on the effects of wholegrain intake in T2DM patients, we have considered studies performed in individuals with clinically established T2DM; changes in fasting and postprandial plasma glucose and glycated hemoglobin (HbA1c) were the main outcomes evaluated in these studies
Summary
Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases with 415 million cases estimated globally in 2015; this number is expected to increase dramatically in the decades reaching 642 million by 2040 [1]. The progressive diffusion of western dietary habits and low physical activity, and the strictly related global increase in overweight/obesity are the major determinants of the growth of T2DM prevalence observed in the last decades together with the increased longevity connected to the improvements of diabetes care [3]. The incidence of T2DM is very high in overweight/obese individuals with visceral adiposity and its linked pathological conditions characterized by interrelated alterations in metabolic and vascular functions such as hyperglycemia, dyslipidemia, insulin resistance, and hypertension [4].
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