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Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. GDM is defined as glucose intolerance of variable severity with onset or first recognition during pregnancy. The purpose of this paper is to produce information on prevalence, screening and diagnosis, pathophysiology and dietary, medical and lifestyle management of GDM.

This literature review aimed to document and record the results of the most updated studies published dealing with dietary, medical and lifestyle factors in managing GDM.

The prevalence of GDM differs worldwide based on population characteristics, race/ethnicity and diagnostic criteria. The pathophysiology of GDM is multifactorial and it is likely that genetic and environmental factors are associated with the occurrence of GDM. Medical nutritional therapy remains the mainstay of GDM management and aerobic and resistance physical activities are helpful adjunctive therapy when euglycemia is not attained by the medical nutritional therapy alone. When diet and exercise fail to achieve glycemic control, pharmacological agents such as insulin therapy and oral hypoglycemic medications are prescribed. Plasma glucose measurement is an essential part of glycemic control during pregnancy, as well as glycemic control can be evaluated using indicators of glycemic control such as hemoglobin A1c (HbA1c), glycated albumin and fructosamine.

This review is a comprehensive review that illustrates the effect of healthy diet, medical therapy and lifestyle change on improving GDM condition.

Starchy foods have been emphasized in the diet for reducing hyperglycemia and hyperinsulinemia. However, all starch containing foods respond differently, depending upon various other factors in food such as the amylose:amylopectin ratio, co‐ingredients, methods of cooking, etc. which also impact its metabolic response. During days of fast, in India, potato and sago are the most commonly used food to provide quick source of energy. The purpose of this paper is to determine the functional and nutritional quality of fasting foods such as potato and sago, having higher amylopectin content, with respect to their relative glycemic and insulin response in normal healthy volunteers.

The postprandial glycemic response to boiled potato and sago khichdi in relation to equal quantity of bread (reference) was compared using Relative Glycemic Potency (RGP) represented as the Glycemic Bread Equivalent (GBE) of foods. Five clinically healthy subjects were fed 100 g of test foods and standard, and their blood glucose and insulin response was recorded at fasting (0 min) and at 30, 60, 90 and 120 min.

It was found that both potato and sago khichdi produced peak glucose response at 30 min and levels returned to baseline within 60 min. The higher amylopectin content which facilitates faster absorption from the gastro‐intestinal tract and into the cell results in the total area under the curve (AUC) glycemic response to potato and sago khichdi to be significantly lower than that of bread (p < 0.05). The total AUC insulin response to potato (p <0.05) and sago khichdi was also lower than that of bread.

Therefore, starch‐based foods rich in amylopectin lead to quicker absorption of sugar to supply the energy to the energy‐deprived cells common in fasting condition.

The paper shows that the starch present in these fasting foods is typically characterized by a higher amylopectin:amylose ratio.

Rice is considered a high glycemic index food. However, the overall glycemic response to whole foods differs based on the presence of co‐components, cooking or processing technique, starch composition, and amount of food consumed. The purpose of this paper is to observe the relative glycemic impact (RGI) of foods based on postprandial glycemic response to equal quantities of test foods and standard‐bread expressed as glycemic bread equivalent (GBE), using rice and its products.

In total, five clinically healthy adult volunteers were fed 50 g test foods and bread on different days after an overnight fast. Blood sugar and insulin levels at fasting state and at 30, 60, 90 and 120 min after consuming food were recorded and corresponding area under the curve was calculated.

The GBE was highest for puffed rice at 107 g, whereas same amount of rice kheer and plain boiled rice induced glycemic response equivalent to 19.5 g and 11 g of bread, respectively. RGI of puffed rice was found to be significantly higher than that of rice kheer and boiled rice (p<0.01). Similarly, the total insulinemic effect of puffed rice (71 g) was found to be significantly higher than that of rice (6 g, p<0.01) and rice kheer (19 g, p<0.05).

Despite being prepared from common raw ingredient, all the three test foods produced varied glycemic and insulin responses. This can be attributed to the different processing conditions, change in nutrient composition and total quantity consumed.

The GBE values may constitute a simple and easy‐to‐use tool for consumers to select food in terms of their predicted glycemic and insulin responses, especially in the diabetic or insulin‐resistant group.

The purpose of this study is to collect and assess the evidence available on the effect of non nutritive sweeteners on appetite, weight and glycemic regulation. As a replacement for sugars, non-nutritive sweeteners (NNSs) are widely being used in different food products with the assumption that these would lower calorie intake and help to manage weight and blood sugar levels better. However, studies using animal models have reported that chronic exposure to NNSs leads to increased food consumption, weight gain and insulin resistance.

Evidence was acquired from systematic reviews or meta-analyses (2016–2021) of relevant clinical studies, especially randomized control trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

The review showed NNSs exposure did not conclusively induce increased food intake or change in subjective appetite ratings. Appetite biomarkers like ghrelin, gastric inhibitory peptide, C-peptide levels and Peptide YY remained mostly unaffected by NNSs. Meta-analyses of human randomized control studies showed a reduced energy intake and body weight. No significant change was seen in blood glucose levels, post-prandial glycemic or insulin response after consumption of NNSs. Adequate evidence is not available to conclusively say that NNSs influence gut health at doses relevant to human use.

Most studies which are prospective cohort, observational and cross-sectional studies suggest that use of NNSs may promote obesity and metabolic syndrome in adults. Such studies are plagued by confounding variables and reverse causation. Mechanistic evidence is mostly based on in-vitro and in-vivo studies. The same causal pathways may not be operative or relevant in humans.

This review of available literature concludes that to achieve specific public health and clinical goals, the safe use of NNSs for the reduction of intakes of free sugars and energy should be explored. This would be possible by educating the consumer about energy compensation and understanding the nutritional content of artificially sweetened products in terms of calories coming from fat and complex carbohydrates used in the product.

This study was, thus, designed with the objective of examining the usefulness of NNSs in human population, especially with respect to insulin regulation, glycemic control and weight management. Well-designed randomized control trials which control for confounding variables are needed to generate high quality evidence.

Adipose tissue accumulation by trapping vitamin D and reducing its level may cause serious side effects. The purpose of this study is to determine the effects of vitamin D supplementation on dehydroepiandrosterone (DHEA), paraoxonase 1 (PON 1), insulin, free fatty acid (FFA), apolipoprotein-AI (Apo-AI) and apolipoprotein B (Apo-B) concentration in obese and overweight participants under low-calorie diet (LCD) program.

Healthy overweight and obese individuals (n = 70) with vitamin D deficiency were randomly assigned into 2 groups to receive either vitamin D supplements (an oral 2,000 IU vitamin D supplement) or placebo for 8 weeks.

All the participants were given an LCD program during the intervention. Vitamin D supplementation led to a significant increase in the levels of 25(OH)D (vitamin D vs placebo groups: 36.6 ± 9.8 vs 19.9 ± 3.5 ng/mL, p < 0.001), PON 1 levels (vitamin D vs placebo groups: 80 ± 25 vs 58 ± 23.2 ng/mL, p = 0.001), DHEA concentration (vitamin D vs placebo groups: 2.3 ± 0.7 vs 1.5 ± 0.6 ng/mL, p < 0.001) and Apo-AI levels (vitamin D vs placebo groups 3.7 ± 0.5 vs 3 ± 0.5 mg/dL, p < 0.001). Besides, intake of vitamin D supplements led to a significant decrease in FFA (vitamin D vs placebo groups: 3.1 ± 0.75 vs 3.5 ± 0.5 ng/mL, p = 0.001). After adjusting the analyses based on baseline levels, age and baseline body mass index measures, significant changes were observed in the insulin levels (0.03 ± 0.06 vs −1.7 ± 0.6 µIU/ml, p = 0.04). But the authors did not find any significant difference in the concentration of Apo-B between groups (vitamin D vs placebo groups: 71.5 ± 35.5 vs 66.6 ± 28.5 mg/dL, p = 0.05).

Overall vitamin D supplementation for eight weeks among vitamin D-deficient obese and overweight participants had beneficial effects on serum DHEA PON 1 FFA insulin and Apo- AI while it did not affect the Apo-B concentration.

The purpose of this paper is to study insulin pump therapy and accurate monitoring of glucose levels in diabetic patients, which are current research trends in diabetology. Both problems have a wide margin for improvement and promising applications in the control of parameters and levels involved.

The authors have registered data for the levels of glucose in diabetic patients throughout a day with a temporal resolution of 5 minutes, the amount and time of insulin administered and time of ingestion. The estimated quantity of carbohydrates is also monitored. A mathematical model for Type 1 patients was fitted piecewise to these data and the evolution of the parameters was analyzed.

They have found that the parameters for the model change abruptly throughout a day for the same patient, but this set of parameters account with precision for the evolution of the glucose levels in the test patients. This fitting technique could be used to personalize treatments for specific patients and predict the glucose-level variations in terms of hours or even shorter periods of time. This way more effective insulin pump therapies could be developed.

The proposed model could allow for the development of improved schedules on insulin pump therapies.

The purpose of this paper is to provide a comprehensive summary of the effect of different dietary approaches on polycystic ovary syndrome (PCOS).

This review represents the history of PCOS, the symptoms, diagnosis, and treatment. It also includes up‐to‐date research articles on different types of diets that have been shown some promising effects in the treatment of PCOS.

PCOS is nowadays considered the most common endocrine abnormality, with a range of 4‐12 per cent of women affected by the syndrome. It has been proven that diet, in addition to exercise and medication, plays an important role in the treatment of PCOS. The proper dietary approach for women with PCOS should focus on the PCOS symptoms and also improve weight loss, increase fertility, and decrease risks of cardiovascular diseases.

This paper provides accessible and comprehensive information on PCOS (since its discovery in 1935) to researchers, nutritionists, and women with PCOS who are interested in the effect of the diet on PCOS management.

Glycemic index (GI) is a physiological basis for ranking carbohydrate foods based on the blood glucose responses they produce after ingestion. Emblica officinalis (E. officinalis) is a medicinal plant that purportedly has hypoglycaemic and hypolipidemic properties. This study aims to determine the glycemic and lipemic responses of freeze-dried E. officinalis powder-incorporated recipes.

Two sets of four equicarbohydrate (50 g) recipes (vegetable cutlet, handvo, muthiya and methi thepla) were developed, one without E. officinalis powder incorporation (standard) and one with E. officinalis powder incorporation at the 2 g level (test). After overnight fasting, 50 g glucose, standard and test recipes were administered to healthy adult volunteers at different instances (each 3–4 days apart) and blood glucose levels were measured using capillary sampling every 15 min for 2 h. The glycemic response and GI values were then calculated.

Among the standard recipes, lowest glycemic response was obtained by methi thepla (60.90 ± 15.54) and highest glycemic response by handvo (90.57 ± 33.88). Incorporation of E. officinalis powder brought about a non-significant reduction in the GI of methi thepla (p = 0.94), vegetable cutlet (p = 0.54), muthiya (p = 0.69) and handvo (p = 0.09). Maximum per cent reduction was for handvo, which shifted from the high to medium GI category. The lipemic response was lowest with muthiya, showing a fall in triacylglycerol (TG) levels (3.9%). E. officinalis powder incorporation in muthiya led to a further fall (7.8%) in TG levels.

Incorporation of freeze-dried E. officinalis powder in Indian recipes can bring about a reduction in the postprandial glycemic and lipemic responses.

Hyperglycemia in type 2 diabetes mellitus increases inflammation through pancreatic beta-cell destruction. Goat milk (kefir) and vitamin D3 have antioxidant and anti-inflammatory properties that can reduce pancreatic beta cells. Increase in total leukocyte count is one of the inflammatory and complication markers of diabetes. This study aims to analyze the effect of fermented goat milk (kefir) fortified with vitamin D3 on total leukocyte counts in diabetic brown rat (Rattus norvegicus).

An experimental design with pre- and post-test methodology of control and experimental groups was used. A total of 24 male Wistar rats were divided into four groups: negative control (K−), positive control (K+), kefir treatment (P1) and kefir fortified with vitamin D₃ treatment (P2). The control group consisted of healthy rats; the other groups consisted of rats which were given streptozotocin–nicotinamide injections. Before and after intervention, fasting blood glucose levels and total leukocytes counts were measured. Blood glucose levels were analyzed using the GOD–PAP method and leukocyte counts were analyzed using an automatic hematological analyzer.

There was a significant decrease in total leukocyte counts in the P2 group (from 26.5 ± 7.7 to 20.4 ± 10.4 [p < 0.05]). However, the decrease in leukocyte count in theP1 group was not significant (from 22.1 ± 9.3 to 16.5 ± 6.2). The decrease in blood glucose levels in theP2 group was −81.4 ± 203.0 but not significant.

Kefir with vitamin D3 fortification can significantly reduce total leukocyte counts in diabetes.