Type 2 diabetes (T2D) incidence has been steadily increasing over the past few decades. Several studies have evaluated the effect of plant-based, vegetarian or vegan diets on the risk of T2D, although their potential benefits need to be confirmed and characterised. We performed a literature search up to 10 July 2025, using the terms/keywords related to plant-based index (PDI), vegetarian/vegan diets and T2D. We included observational non-experimental studies evaluating adherence to such diets in adult subjects assessing T2D risk. We specifically considered overall PDI and related healthy PDI (hPDI) and unhealthy PDI (uPDI), assessing intake of different food groups. We included 36 studies published between 1999 and 2025. We found an inverse association between adherence to vegetarian/plant-based dietary patterns and T2D risk. This association was stronger, though statistically imprecise, for the vegan diet (RR = 0·65, 95 % CI 0·42, 1·00) and for lacto-ovo-vegetarian diet (RR = 0·68, 0·57, 0·82). For studies using plant-based indices, the RR were 0·82 (0·69, 0·82), 0·76 (0·69, 0·82) and 1·13 (0·98, 1·30) for overall PDI, hPDI and uPDI, respectively. In the dose–response meta-analysis, overall PDI and hPDI showed an inverse and almost linear association with T2D risk. Conversely, adherence to uPDI directly correlated with T2D risk. Overall, adherence to vegan/vegetarian diets may reduce T2D risk, while an unhealthy plant-based diet appears to linearly increase disease risk, indicating caution in the consumption of such unhealthy foods even if of plant origin. The beneficial association between vegetarian and healthy plant-based diets may have major public health implications.

Impaired glycaemic control is a major risk factor for developing type 2 diabetes (T2D), a worldwide health epidemic intrinsically linked to diet and obesity. Whey proteins (WP) are increasingly popular supplements that are a rich source of branched-chain amino acids (BCAA), essential for muscle protein synthesis and metabolic regulation. In humans, fasting plasma concentrations of BCAA are maintained around 350 µM but become chronically elevated by 10–25% in persons with T2D. Little is known about whether BCAA from WP impacts circulating BCAA concentrations and contributes to this phenomenon. This narrative review used a systematic search approach with relevant keywords to identify evidence from randomised controlled trials in normoglycaemic humans and those with insulin resistance or T2D, on the effects of WP intake on plasma BCAA and glycaemic control. This review is, to the authors’ knowledge, the first to specifically examine the effects of WP intake on plasma BCAA concentrations in relation to glycaemic control. Whilst the majority of acute studies identified (n = 6) reported that WP consumption between 10 and 50 g significantly elevates postprandial BCAA and insulin responses (as evidenced by peak concentration and/or area under the curve), evidence from chronic studies (n = 3) report inconsistent findings on the impact of 9–51 g of WP/d on fasting BCAA and glycaemic control (for example, fasting glucose and insulin, insulin clearance). Findings from this literature review highlight the need for further studies that investigate the relationship between WP consumption with BCAA and glycaemic control, and to determine underlying mechanisms of action.

Parkinson’s disease (PD) is a severe neurodegenerative disorder characterized by prominent motor and non-motor (e.g., cognitive) abnormalities. Notwithstanding Food and Drug Administration (FDA)-approved treatments (e.g., L-dopa), most persons with PD do not adequately benefit from the FDA-approved treatments and treatment emergent adverse events are often reasons for discontinuation. To date, no current therapy for PD is disease modifying or curative. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are central nervous system (CNS) penetrant and have shown to be neuroprotective against oxidative stress, neuroinflammation, and insulin resistance, as well as promoting neuroplasticity. Preclinical evidence suggests that GLP-1RAs also attenuate the accumulation of α-synuclein. The cellular and molecular effects of GLP-1RAs provide a basis to hypothesize putative therapeutic benefit in individuals with PD. Extant preclinical and clinical trial evidence in PD provide preliminary evidence of clinically meaningful benefit in the cardinal features of PD. Herein, we synthesize extant preclinical and early-phase clinical evidence, suggesting that GLP-1RAs may be beneficial as a treatment and/or illness progression modification therapeutic in PD.

The aim of the study is to assess the dietary knowledge and practices of Lebanese patients with diabetes not receiving dietary counselling in a low-income setting. A cross-sectional study was conducted among 317 Lebanese adult patients, not receiving dietary counselling in North Lebanon. Patients completed a questionnaire evaluating their sociodemographic, health and clinical characteristics as well as their dietary knowledge (DK) and practices. The mean total DK score as well as the mean scores for each category were calculated for the whole sample, transformed into percentages of maximal score and classified into poor (< 50%), good (50–75%) and adequate (> 75%). Patients had a good, but not optimal total DK (51.66%). Similarly, they also had a good knowledge related to carbohydrates (52.16%) and fat (52.5%), and to food type (60.83%). On the other hand, they had a poor knowledge about food choices (35.66%) and protein (44%). Linear regression analysis revealed that a higher educational level (β = 1.96, p < 0.001), choosing whole grains (β = 1.19, p = 0.002), living with a partner (β = 1.01, p = 0.007), being recently diagnosed with diabetes (β = –1.23, p = 0.012) were positively associated with a better DK. Furthermore, patients who suffered from type I diabetes had a better DK compared to those suffering from type 2 diabetes (β = –1.31, p = 0.016). The nutritional knowledge of the patients with diabetes not receiving dietary counselling is good but not optimal. Dietitians and doctors should collaborate to provide patient-centred and individualised dietary education to patients with diabetes.

The Weill Cornell Heart to Heart Community Outreach Campaign (H2H) is a free outreach program that provides mobile health screenings. The program brings medical and nursing faculty and students to the underserved, uninsured communities of New York City. Participants are screened for diabetes and heart disease risk factors through onsite exams, including point of care blood tests. If an abnormality is found, they receive a medical consultation to offer personalized advice and referrals to free/low-cost clinics when needed. The goal is to help underserved individuals understand their cardiometabolic health and to promote early intervention. This article describes the development of the program, including factors that were essential to the collaboration, challenges faced, barriers to implementation, and its evolution throughout the first 12 years. The program has benefited from strong foundational program leadership, effective inter-institutional collaboration, and maintaining community trust.

This study aimed to investigate the mechanisms by which the association between maternal hyperglycemia and postnatal high-fat diet (HFD) exposure compromises metabolic parameters and hepatic autophagy in adult female pups. For this, Sprague Dawley rats, female pups from nondiabetic (control = FC) or diabetic (FD) mothers, were fed a standard diet (SD) or HFD from weaning until adulthood (n minimum = 5 rats/group): FC/SD, FC/HFD, FD/SD, and FD/HFD. In adulthood, these rats were tested with the oral glucose tolerance test, euthanized, and serum biochemistry parameters were analyzed. Liver samples were collected to evaluate cytokines, redox status, and protein expression autophagy and apoptosis markers. Histomorphometric analyses and an assessment of lipofuscin accumulation were also performed to reflect incomplete autolysosomal digestion. The FC/HFD, FD/SD, and FD/HFD groups showed glucose intolerance and an increased number of hepatocytes. Furthermore, FD/SD and FD/HFD rats showed hyperlipidemia and insulin resistance. Adaptations in hepatic redox pathways were observed in the FD/SD group with increased antioxidant defense marker activity. The FD/SD group also exhibited increased autophagy protein expression, such as p-AMPK, LC3-II/LC3-I, and p62/SQSTM1, lipofuscin accumulation, and caspase-3 activation. After exposure to HFD, the adult female pups of diabetic rats had a reduced p-AMPK and LC3-II/LC3-I ratio, the presence of steatosis, oxidative stress, and inflammation. The reduction of autophagy, stimulated by HFD, may be of vital importance for the susceptibility to metabolic dysfunction-associated fatty liver disease induced by maternal diabetes.

This project evaluated the outcomes of acceptance and commitment therapy (ACT)-informed interventions for individuals with Type 1 or Type 2 diabetes mellitus experiencing mental health distress related to their condition or self-management burden. A within-subjects design evaluated the effectiveness of ACT-informed interventions using pre- and post-psychological wellbeing and diabetes specific outcome measures and HbA1C data. The interventions were part of the Croydon Community Diabetes service which began in October 2020. Fifty-six service users completed psychological wellbeing outcome measures (PHQ-9, GAD-7 and CORE-10) and 38 of these service users fully completed the diabetes specific measure (either DDS or the PAID). Thirty-nine service users had HbA1C data before the start of treatment and following the end of treatment. Wilcoxon’s signed rank test was used to analyse psychological outcomes and HbA1c data. Descriptive statistics were used for diabetes specific measures due to small sample sizes. Statistically significant reductions in levels of depression, generalised anxiety, and general psychological distress were found following ACT-informed interventions. Statistically significant reductions were also observed for HbA1c readings. Although inferential statistics were not used, the data highlighted that n=21 and n=14 reported reduction in scores on the DDS and PAID, respectively. Preliminary evidence suggests that ACT-informed interventions in an NHS community diabetes clinic for a sample of people living with Type 1 or Type 2 diabetes are associated with improved psychological wellbeing and diabetes distress.

Key learning aims

1. (1) To learn about the current evidence base and missing gaps in research on the use of acceptance and commitment therapy (ACT) for people living with Type 1 or Type 2 diabetes mellitus.

2. (2) To provide clinicians with an example of brief individualised ACT informed psychological interventions based on a sample of people living with diabetes in South London.

3. (3) To learn about the implementation of ACT informed psychological interventions in a naturalistic evaluation of a community Diabetes NHS service that reflects realistic treatment delivery.

4. (4) Through the limitations discussed in this paper, we provide future suggestions for psychologists working in diabetes care for evaluating their service in a naturalistic setting. This includes the collection of data through various sources such as the use of physical health measures and therapy process measures.