Gkouskou Kalliopi K, Grammatikopoulou Maria G, Lazou Evgenia, Sanoudou Despina, Goulis Dimitrios G, Eliopoulos Aristides G
Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Embiodiagnostics Biology Research Company, Heraklion, Greece.
Front Nutr. 2022 Feb 21;9:772243. doi: 10.3389/fnut.2022.772243. eCollection 2022.
Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder of multifactorial etiology that includes genetic and dietary influences. By addressing the latter, medical nutrition therapy (MNT) contributes to the management of T2DM or pre-diabetes toward achieving glycaemic control and improved insulin sensitivity. However, the clinical outcomes of MNT vary and may further benefit from personalized nutritional plans that take into consideration genetic variations associated with individual responses to macronutrients. The aim of the present series of -of-1 trials was to assess the effects of genetically-guided vs. conventional MNT on patients with pre-diabetes or T2DM. A quasi-experimental, cross-over design was adopted in three Caucasian adult men with either diagnosis. Complete diet, bioclinical and anthropometric assessment was performed and a conventional MNT, based on the clinical practice guidelines was applied for 8 weeks. After a week of "wash-out," a precision MNT was prescribed for an additional 8-week period, based on the genetic characteristics of each patient. Outcomes of interest included changes in body weight (BW), fasting plasma glucose (FPG), and blood pressure (BP). Collectively, the trials indicated improvements in BW, FPG, BP, and glycosylated hemoglobin (HbA1c) following the genetically-guided precision MNT intervention. Moreover, both patients with pre-diabetes experienced remission of the condition. We conclude that improved BW loss and glycemic control can be achieved in patients with pre-diabetes/T2DM, by coupling MNT to their genetic makeup, guiding optimal diet, macronutrient composition, exercise and oral nutrient supplementation in a personalized manner.
2型糖尿病（T2DM）是一种病因多因素的异质性代谢紊乱疾病，包括遗传和饮食影响。通过解决后者，医学营养治疗（MNT）有助于T2DM或糖尿病前期的管理，以实现血糖控制和改善胰岛素敏感性。然而，MNT的临床结果各不相同，可能会从个性化营养计划中进一步受益，该计划考虑了与个体对常量营养素反应相关的基因变异。本系列单组前后对照试验的目的是评估基因指导的MNT与传统MNT对糖尿病前期或T2DM患者的影响。对三名患有上述任一诊断的白种成年男性采用了准实验性交叉设计。进行了完整的饮食、生物临床和人体测量评估，并根据临床实践指南应用传统MNT 8周。在一周的“洗脱期”后，根据每位患者的基因特征，再开具精准MNT处方8周。感兴趣的结果包括体重（BW）、空腹血糖（FPG）和血压（BP）的变化。总体而言，试验表明基因指导的精准MNT干预后，BW、FPG、BP和糖化血红蛋白（HbA1c）有所改善。此外，两名糖尿病前期患者的病情均得到缓解。我们得出结论，通过将MNT与糖尿病前期/T2DM患者的基因组成相结合，以个性化方式指导最佳饮食、常量营养素组成、运动和口服营养补充，可以实现体重减轻和血糖控制的改善。
