Latest Research

Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies

A systematic review conducted in 2025 by Talebi S et. al., sought to examine epidemiological studies to investigate the association between dietary total fatty and fatty acids and the risk of gestational diabetes. A total of twenty-one prospective studies were included in the study. Results indicated that a dose-response meta analyses suggested every 10% increment in total energy from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was associated with a small but statistically significant increase in gestational diabetes risk.

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Impact of Maternal Macronutrient Intake on Large for Gestational Age Neonates’ Risk Among Women with Gestational Diabetes Mellitus: Results from the Greek BORN2020 Cohort

A systematic review conducted in 2025 by Talebi S et. al., sought to examine epidemiological studies to investigate the The purpose of the study by Siargkas A et. al., 2025 was to assess the effect of maternal macronutrient composition on the risk of large for gestational age (LGA) neonates among women with gestational diabetes mellitus (GDM).  Data was collected using a validated Food Frequency Questionnaires (FFQs) was collected among 797 eligible pregnant women from Northern Greece who developed GDM. Results indicated that higher dietary fiber and vegetable protein intake before pregnancy were significantly associated with an increased risk of LGA among women with normal BMI. During early pregnancy, a higher percentage of total carbohydrate and elevated vegetable protein intake also increased LGA risk. The study concluded that maternal macronutrient intake prior to and during early pregnancy may influence LGA risk in GDM, with distinct patterns according to pre-pregnancy BMI. These findings underscore the importance of tailoring dietary recommendations—especially regarding fiber, vegetable protein, carbohydrates, and saturated fat—to prevent the risk of LGA in women with GDM.

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Fasting as an intervention to alter the impact of simulated night-shift work on glucose metabolism in healthy adults: a cluster randomised controlled trial

Night-shift workers have an increased risk for obesity and type 2 diabetes, potentially due to circadian disruption and impaired glucose metabolism. This study aimed to examine the effects of eating a meal versus a snack versus fasting at night on glucose metabolism during a simulated night-shift in healthy non-shift workers. Individuals were randomized to one of three conditions: fasting at night (n=20), snack at night (n=17), and meal at night (n=18) during a 6-day stay at the laboratory. Participants were provided food at their calculated energy balance, with macronutrient distribution similar across the conditions. Glucose, insulin, and non-esterified fatty acids (NEFA) area under the curve was determined in response to a 75-gram oral glucose tolerance test (OGTT) performed prior to and after 4 consecutive nights of shift work. Insulin sensitivity, insulinogenic and disposition indexes were calculated. Individuals who ate a meal or snack during the simulated night shift had reduced glucose tolerance, whereas those who fasted at night maintained glucose tolerance, indicating that meal timing is effective for reducing impairments in glucose metabolism due to night shift work. Recommendations on meal-timing could be an effective addition to dietary guidance for certain industries to reduce the issue of metabolic disease in night shift workers.

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Diabetes Overtreatment and Hypoglycemia in Older Patients With Type 2 Diabetes on Insulin Therapy: Insights From the HYPOAGE Cohort Study

This study was undertaken as T2D overtreatment is a common condition in older people, tending to reflect more intensive treatment than needed.  Surprisingly, the association between T2D overtreatment and hypoglycemia has never been studied.  This is the first study to use CGM (continuous glucose monitor) data to explore overtreatment and hypoglycemia in older adults with T2D from prospective high quality multicenter data.
This was an ancillary study of the HYPOAGE Cohort Study which was conducted from November 2017 to March 2020 in six French clinics.  Patient profile: > or = to 75 years, T2D >1 year, treated with glucose lowering therapy >6 months, with a baseline HbA1c and with >2 SMBG measurements per day.  One hundred thirty-four participants (41% female, 81.6 +/- 5.4 years) were selected meeting study criteria and wore a CGM for 28 days. Data during this period were collected and analyzed. Two different proxy definitions of T2D Overtreatment were evaluated, these were taken from previous studies:

• Fixed Proxy Definition: HbA1c < 7.0% (53 mmol/mol)

• Individualized Proxy Definition: HbA1c <7.0% (53 mmol/mol), 
  <7.5% (58 mmol/mol) and <8.0% (64 mmol/mol) for patients in good, intermediate and poor health status, respectively.

Patients were placed into the individual proxy definition if they met Blaum Classification. Blaum Classification is a way to categorize older people with T2D based on their functional status. It is used to predict health outcomes and adjust diabetes management plans appropriately. Sixty-seven patients met the Fried criteria for frailty (weight loss, exhaustion, low physical activity, slowness and weakness), fifty-seven had malnutrition, 29 were nursing home residents. The researcher’s primary outcome was >1% TBR (time below range) or <70 per the CGM readings. The secondary outcomes were >1% of level 1 TBR (54-69 mg/dL), level 2 TBR (<54 mg/dL), and the occurrence of >1 hypoglycemic event (<70 mg/dL) as measured by SMBG. Conclusions show no association between the proxy definitions of diabetes overtreatment and occurrence of hypoglycemia in insulin treated older adults having T2D.   The individualized definition fared better than the fixed definition, however there was no significant difference between the two.  Diabetes overtreatment based on HbA1c could not predict hypoglycemia. The authors identify the main issue with these proxy definitions is a reliance solely on the HbA1c.  Though HbA1c levels are effective in monitoring glycemic control over a designated time period, previous research has demonstrated a weak link between HbA1c and hypoglycemia. This study supports prior research. The authors challenge the use of these proxy definitions for the detection of hypoglycemia.  More study is recommended and the necessity for a revised proxy definition is emphasized.

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Effectiveness of Continuous Glucose Monitoring on Short-Term, In-Hospital Mortality Among Frail and Critically Ill Patients With COVID-19: Randomized Controlled Trial

Diabetes and hyperglycemia are linked to increased risk of mortality and morbidity with people who have COVID-19. A study took place at Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine at Lingang Campus. The study used two groups in the Intensive Care Unit (ICU) who were also diagnosed with COVID 19. The sample size (after drop out and eligibility) was 124 people in the ICU. There were two groups; one group used Point of Care Testing (POCT) (n=62) and the other group used a Continuous Glucose Monitor (CGM) (n=62). The CGM group wore a Freestyle Libre to monitor blood glucose control. Results after the 28 day study revealed thirteen deaths in the POCT group and two deaths in the CGM group. The average length of stay in the CGM group was 10 days and the average length of stay in the POCT group was 14 days. The CGM group had lower mortality and decreased length of stay compared to the POCT group. Overall the study concluded that maintaining tight blood glucose control in critically ill patients is an integral part of patient care.

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Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: The Environmental Determinants of Islet Autoimmunity (ENDIA) study 

This study examines the association between dietary patterns during pregnancy and maternal and birth outcomes in women with Type 1 Diabetes (T1D). Researchers analyzed 615 pregnancies in women with T1D from the ENDIA study using food frequency questionnaires and physical activity assessments. Findings suggest that a "fresh food" dietary pattern (rich in vegetables, fruit, nuts, fish, and whole grains) was linked to a 63% lower risk of pre-eclampsia and a 65% reduction in premature birth. Conversely, a "processed food" dietary pattern (high in refined grains, processed meats, and snacks) was associated with increased birth weight. The study highlights the importance of a nutrient-dense diet during pregnancy and suggests that small, achievable dietary changes may significantly improve outcomes for both mother and baby.

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Low carbohydrate diets, glycaemic control, enablers, and barriers in the management of type 1 diabetes: A mixed methods systematic review.  

This mixed methods systematic review examines the effectiveness of low and very low carbohydrate diets (LCD/VLCD) on HbA1c levels and explores the lived experiences of adults with Type 1 Diabetes (T1D) following these dietary patterns. Seventeen studies were included in the review, with quantitative findings showing inconclusive evidence on whether these diets significantly improve glycemic control. In contrast, qualitative studies highlighted perceived benefits, including better glycemic stability, weight loss, and improved well-being. However, barriers such as difficulty in insulin adjustments, restrictive food choices, and lack of professional guidance were reported. The review concludes that while LCD/VLCDs may offer benefits for some individuals, larger and longer-term studies are needed to determine their efficacy in T1D management.

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Suboptimal adherence to a gluten-free diet in adults with both type 1 diabetes and celiac disease using urinary gluten immunogenic peptide measurement  

This study investigates the adherence to a gluten-free diet (GFD) in adults with both Type 1 Diabetes (T1D) and Celiac Disease (CeD) using urinary gluten immunogenic peptide (GIP) measurement as an objective marker of gluten intake. The research involved 197 participants divided into three groups: (1) T1D + CeD, (2) CeD only, and (3) T1D only. Results showed that 15% of individuals with T1D + CeD had detectable gluten peptides in their urine, while none in the CeD-only group tested positive. The study highlights the challenges of dietary adherence in individuals managing both conditions, suggesting that urinary GIP testing may be a useful tool in clinical follow-up to detect management and improve dietary management. The findings emphasize the need for enhanced patient education and follow-up strategies to ensure adherence to a gluten-free diet and improve health outcomes in this population.

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Disordered eating attitudes and behaviors among older adults with type 1 diabetes: An exploratory study  

This study examines disordered eating behaviors (DEBs) among older adults with Type 1 Diabetes (T1D), a topic that has been largely underexplored. Using the Diabetes Eating Problem Survey-Revised (DEPS-R), researchers assessed 77 adults aged 65 and older from a university-affiliated hospital system. Results showed that 5.2% of participants had clinically significant DEBs, with higher DEPS-R scores correlating with increased body mass index (BMI), but not with HbA1c levels. Women reported higher DEBs than men, highlighting potential sex-specific differences. The study underscores the importance of routine screening for DEBs in older adults with T1D and suggests that integrating weight management strategies into diabetes care could enhance overall health outcomes in this population.

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Is there anything left to eat? A lived experience insight of following a restrictive type 1 diabetes and dialysis diet  

This study explores the lived experiences of individuals managing both Type 1 Diabetes (T1D) and End-Stage Kidney Disease (ESKD) while following a highly restrictive diet. Using an auto/biographical approach, the authors examine the psychological, social, and emotional burdens of dietary limitations imposed by medical nutrition therapy. The findings highlight five key themes: food as a symbol of belonging, the illusion of normalcy, the defining role of blood sugar and weight metrics, the perception of dietary restriction as virtue, and the emotional impact of an ESKD diagnosis. The study emphasizes the need for more patient-centered dietary guidance that balances medical recommendations with real-life challenges, including eating disorders, quality of life concerns, and mental health impacts. The authors call for greater patient involvement in research and improved support from healthcare providers to enhance adherence and long-term outcomes.

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