Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients

Background and aims: Lifestyle intervention, aimed at weight loss and increasing physical activity, is widely known as the first-line treatment in diabetes. Adherence to a medical nutritional therapy (MNT) is even more relevant in patients on insulin therapy. However, data on the relationship betwee...

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Main Authors: Caterina Formichi, Sonia Caprio, Stefano Auddino, Felicia Rizza, Barbara Paolini, Laura Nigi, Francesco Dotta
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Human Nutrition & Metabolism
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666149725000337
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author Caterina Formichi
Sonia Caprio
Stefano Auddino
Felicia Rizza
Barbara Paolini
Laura Nigi
Francesco Dotta
author_facet Caterina Formichi
Sonia Caprio
Stefano Auddino
Felicia Rizza
Barbara Paolini
Laura Nigi
Francesco Dotta
author_sort Caterina Formichi
collection DOAJ
description Background and aims: Lifestyle intervention, aimed at weight loss and increasing physical activity, is widely known as the first-line treatment in diabetes. Adherence to a medical nutritional therapy (MNT) is even more relevant in patients on insulin therapy. However, data on the relationship between diet composition and glycemic control indexes derived from continuous glucose monitoring (CGM) in type 2 diabetes (T2D) are scarce and inconsistent. Our aim was to evaluate the association between adherence do Mediterranean diet (MD) and CGM metrics in a cohort of T2D patients treated with insulin. Methods and results: We retrospectively collected data of 25 patients with T2D on insulin therapy, at the Diabetes Unit of University Hospital in Siena. They were prescribed a flash glucose monitoring (FGM) system and accepted to answer the MEDLIFE questionnaire, a validated tool designed to explore the adherence to MD. Adherence to MD did not seem to influence glycemic control indexes in our cohort. It is worth mentioning that the risk of hypoglycemia and time spent in hypoglycemia was found to be highly influenced by alcohol consumption, even in minimal amounts (according to national guideline recommendations). Conclusion: Nutritional counselling for patients with insulin-treated T2DM should include a focus on alcohol consumption – ideally to be avoided - and related hypoglycemic risk.
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spelling doaj-art-2ddff4fcaecd47dfaac37a20f02bdad52025-08-20T03:01:46ZengElsevierHuman Nutrition & Metabolism2666-14972025-09-014120033010.1016/j.hnm.2025.200330Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patientsCaterina Formichi0Sonia Caprio1Stefano Auddino2Felicia Rizza3Barbara Paolini4Laura Nigi5Francesco Dotta6Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100, Siena, Italy; Corresponding author.Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100, Siena, ItalyDepartment of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100, Siena, ItalyDepartment of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100, Siena, ItalyDietetics and Clinical Nutrition Unit, Azienda Ospedaliera Universitaria Senese, Viale Bracci 1-16, 53100, Siena, ItalyDepartment of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100, Siena, ItalyDepartment of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100, Siena, ItalyBackground and aims: Lifestyle intervention, aimed at weight loss and increasing physical activity, is widely known as the first-line treatment in diabetes. Adherence to a medical nutritional therapy (MNT) is even more relevant in patients on insulin therapy. However, data on the relationship between diet composition and glycemic control indexes derived from continuous glucose monitoring (CGM) in type 2 diabetes (T2D) are scarce and inconsistent. Our aim was to evaluate the association between adherence do Mediterranean diet (MD) and CGM metrics in a cohort of T2D patients treated with insulin. Methods and results: We retrospectively collected data of 25 patients with T2D on insulin therapy, at the Diabetes Unit of University Hospital in Siena. They were prescribed a flash glucose monitoring (FGM) system and accepted to answer the MEDLIFE questionnaire, a validated tool designed to explore the adherence to MD. Adherence to MD did not seem to influence glycemic control indexes in our cohort. It is worth mentioning that the risk of hypoglycemia and time spent in hypoglycemia was found to be highly influenced by alcohol consumption, even in minimal amounts (according to national guideline recommendations). Conclusion: Nutritional counselling for patients with insulin-treated T2DM should include a focus on alcohol consumption – ideally to be avoided - and related hypoglycemic risk.http://www.sciencedirect.com/science/article/pii/S2666149725000337HypoglycemiaMediterranean dietFGM
spellingShingle Caterina Formichi
Sonia Caprio
Stefano Auddino
Felicia Rizza
Barbara Paolini
Laura Nigi
Francesco Dotta
Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients
Human Nutrition & Metabolism
Hypoglycemia
Mediterranean diet
FGM
title Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients
title_full Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients
title_fullStr Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients
title_full_unstemmed Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients
title_short Adherence to the mediterranean diet and risk of hypoglycemia in insulin-treated type 2 diabetic patients
title_sort adherence to the mediterranean diet and risk of hypoglycemia in insulin treated type 2 diabetic patients
topic Hypoglycemia
Mediterranean diet
FGM
url http://www.sciencedirect.com/science/article/pii/S2666149725000337
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