JMIR Publications

ABSTRACT

Background:

Background:

The prevalence of type-2 diabetes (T2D) has increased consistently and this type of diabetes is often preceded by a condition known as prediabetes (PD). The major contributor to the progression of PD to T2D is the chronic consumption of diets high in fat and carbohydrates. However, recent reports indicate that PD can be reversed through the use of different dietary interventions composed of low carbohydrate and low fat. This systematic review aims to evaluate the beneficial effects of three diets: prebiotics, Mediterranean, and plant-based diets on gut microbiota and glucose homeostasis in patients with PD/T2D.

Objective:

Objectives: This review aims to provide a thorough synthesis of existing literature concerning the impact of prebiotics, Mediterranean, and plant-based dietary interventions on gut microbiota composition and glucose regulation in individuals diagnosed with prediabetes or type-2 diabetes.

Methods:

Methods:

This review will be developed according to the 2020 PRISMA guidelines and checklist. The databases that will be used include PubMed, EBSCOhost, and Google Scholar. We will search for studies that assessed the effect of prebiotics, Mediterranean, and plant-based dietary intervention on gut composition and glycaemic indexes in prediabetic or type 2 diabetic patients. Studies will be screened by titles, abstracts, and keywords, followed by identifying the full-text articles. All studies that will pass the quality assessment will be included. Data extraction will be performed individually by three independent reviewers and discrepancies between them will be resolved by the fourth reviewer. To evaluate the risk of bias, the Downs and Black checklist will be used. If homogenous data is obtained then a meta-analysis will be conducted using a forest plot from the Review Manager software version 5.4 (RevMan). The strength of evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE).

Results:

Results:

This review will identify all the beneficial effects of prebiotics, Mediterranean, and plant-based dietary interventions on the intestinal flora and glucose homeostasis in prediabetic states and type 2 diabetes. The outcomes of this protocol will also guide future studies that can developed to further evaluate the effectiveness of these dietary interventions on other markers associated with the gut and immune function.

Conclusions:

Conclusions:

The results of this review will assess the correlation between enhancing microbial diversity and glycemic management in individuals with prediabetes and type 2 diabetes. Furthermore, these dietary interventions are anticipated to improve glucose homeostasis in prediabetes and type 2 diabetes individuals. Clinical Trial: Systemic Review Registration Details: This systematic review has been registered at the International Prospective Registry of Systematic Reviews (CRD42023478352).