Abstract

Dietary management plays a central role in the prevention and control of diabetes mellitus, particularly type 2 
diabetes (T2D), which constitutes the majority of global diabetes cases. This evidence synthesis examines the role 
of diet in diabetes management by integrating findings from systematic reviews, meta-analyses, and key clinical 
trials assessing dietary patterns, nutrient composition, and eating behaviors across diverse populations. The 
review highlights the physiological mechanisms linking diet to glucose homeostasis, insulin sensitivity, and 
pancreatic β-cell function, emphasizing the influence of carbohydrate quality and quantity, dietary fiber, fatty acid 
composition, meal timing, and food processing on glycemic outcomes. Evidence consistently supports the benefits 
of high-fiber, whole-grain, plant-based, and Mediterranean dietary patterns in improving glycemic control and 
reducing diabetes risk, while diets high in ultra-processed foods and added sugars are associated with adverse 
metabolic effects. Nutrient-specific considerations, including protein sources, micronutrients, and antioxidants, 
further modify disease progression, particularly in individuals with comorbid conditions such as renal disease. The 
synthesis also underscores the importance of dietary adherence, behavioral strategies, and patient-centered care, as 
well as the need for tailored recommendations for special populations. Despite strong evidence supporting dietary 
intervention, gaps remain regarding long-term outcomes, comparative effectiveness, and implementation across 
diverse socio-cultural contexts. Addressing these gaps is essential to optimizing dietary strategies as a cornerstone 
of diabetes management.