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This systematic review examines the impact of dietary fiber intake on insulin resistance in individuals with type 2 diabetes mellitus (T2DM). Given the global rise in T2DM prevalence and the central role of insulin resistance in its pathophysiology, there is an increasing emphasis on nonpharmacological interventions, such as dietary fiber, to manage glycemic outcomes. A comprehensive search was conducted across six databases including PubMed, Scopus, Web of Science, ProQuest, CINAHL, and CENTRAL, focusing exclusively on randomized controlled trials (RCTs) up to June 2022. Thirteen RCTs, involving a total of 641 participants, were included in the final synthesis. The interventions varied in fiber type (soluble, insoluble, and mixed), source (whole grains, legumes, flaxseed, composite flour), and dosage (5-50 g/day), with durations ranging from 1 to 6 months. Findings consistently demonstrated that dietary fiber, especially soluble and mixed types, significantly improved insulin resistance as measured by HOMA-IR and related indices. Additionally, notable improvements were observed in fasting glucose, HbA1c, LDL cholesterol, and body weight in several trials. While the results are promising, limitations, such as short study durations, small sample sizes, heterogeneity in intervention protocols, and limited long-term data, constrain broader generalization. Despite these challenges, the evidence strongly supports dietary fiber as an effective adjunct in managing insulin resistance in T2DM. The review underscores the need for longer-duration, multicenter RCTs with standardized fiber interventions to confirm findings and inform clinical practice. Dietary fiber should be integrated into individualized diabetes management strategies to enhance metabolic outcomes and overall health.

Abstract licence: CC BY-NC-ND

Background: Hypertensive disorders of pregnancy (HDP), particularly gestational hypertension and preeclampsia, are major causes of maternal and perinatal morbidity. Metabolic disorders such as gestational diabetes mellitus (GDM), type 2 diabetes mellitus (T2DM), obesity, and polycystic ovary syndrome (PCOS) share mechanisms with HDP, including insulin resistance, inflammation, oxidative stress, endothelial dysfunction, and placental maladaptation. Metformin may influence these pathways, but its clinical effect on hypertensive outcomes remains uncertain. Methods: A focused narrative review was conducted using structured, targeted searches of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for literature published primarily from January 2015 through March 2026, supplemented by landmark studies, clinical guidelines, randomized trials, large observational cohorts, systematic reviews, meta-analyses, and mechanistic and placental studies. Evidence was selected for its relevance to the predefined phenotype-based framework and synthesized qualitatively across mechanistic, clinical, and translational domains. Results: Metformin improves insulin sensitivity and may reduce gestational weight gain, metabolic stress, inflammatory signaling, and oxidative stress. Some randomized trials and meta-analyses in GDM, obesity, and PCOS suggest lower rates of pregnancy-induced hypertension or preeclampsia, whereas recent randomized and population-based studies report neutral effects. Findings are limited by heterogeneous populations, late treatment initiation, variable comparators, supplemental insulin use, inconsistent HDP definitions, and insufficient statistical power. Conclusions: Metformin may act as a metabolic and vascular modifier in selected pregnancies, but current evidence does not support its routine use specifically for HDP prevention. Its public health value lies primarily in accessible metabolic treatment and integration into comprehensive antenatal and postpartum risk reduction pathways, rather than replacement of aspirin, blood pressure surveillance, or maternal-fetal monitoring.

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BackgroundNon-oil-seed pulses offer a plant-based source of dietary protein and further nutritionally valuable nutrients such as essential micronutrients and dietary fiber, making them a key component of sustainable diets emphasizing plant protein. They are also a relevant dietary source of carbohydrates with a low glycemic index.ObjectiveThis systematic review aimed to evaluate the acute effects of a variety of non-oil-seed pulses on various parameters of cardiometabolic health, hunger, and satiety.MethodsIn this systematic review, a literature search in the PubMed, Cochrane Library, and Scopus databases was conducted, and 40 human intervention studies were identified that investigated the effects of non-oil-seed pulses on postprandial metabolic events.ResultsMost of the articles in this review reported that non-oil-seed pulses cause lower glucose (28 of 40 studies) and insulin (16 of 24 studies) responses than other starchy foods in the control groups (mainly wheat-flour-based products or white rice). These results were reported for a variety of non-oil-seed pulses and pulse products. Additionally, 3 of 5 studies found a significantly reduced feeling of hunger following meals enriched with pulses compared with the control meal, while the remaining 2 studies found a nonsignificant reduction. Although the studies examining satiety and fullness found increased satiation following pulse-enriched meals, only 1 of 6 studies found a significantly greater increase in satiety compared with the control, and 3 of 6 studies found a significantly greater increase in fullness. Other study variables, such as parameters of lipid metabolism and vascular function, have only been investigated in a few studies, and those studies mostly reported no significant effects.ConclusionThis systematic review confirmed that non-oil-seed pulses can attenuate postprandial glycemia and lipemia and can therefore be classified as low-glycemic food. Future human intervention studies should focus on the acute and chronic effects of non-oil-seed pulses on further health-related parameters, such as inflammatory markers and vascular function.Systematic review registrationPROSPERO registration No. CRD42023471539.

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Background: Guar (Cyamopsis tetragonoloba), locust bean (Ceratonia siliqua), fenugreek (Trigonella foenum-graecum), and tara (Caesalpinia spinosa) are plant-derived materials that contain galactomannans as their major polysaccharide component. Galactomannans are soluble, highly viscous, and fermentable dietary fibers widely used in the food, pharmaceutical, and cosmetic industries because of their favorable technological properties. Methods: We performed our systematic search on 16 April 2026, in MEDLINE (via PubMed), Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL), without language restrictions. Eligible randomized controlled trials compared the effects of guar gum, locust bean gum, and fenugreek on glycemic parameters, lipid profile, and body weight-related outcomes in healthy adults or patients with metabolic disorders. Results: A total of 50 randomized controlled trials were included in the analysis. Of these, 27 investigated guar gum, 20 fenugreek (12 seed powder, 7 seed extract, 1 leaf extract), two mixed galactomannan preparations, and one locust bean gum intervention. Considerable heterogeneity was observed across studies regarding participant characteristics, intervention doses, and treatment duration. Nevertheless, fenugreek-derived preparations consistently improved glycemic outcomes. In contrast, guar gum demonstrated more consistent effects on lipid parameters. Effects on body weight and body mass index were less consistent across studies. Conclusions: Our findings suggest that the metabolic effects of galactomannans are source-dependent, with fenugreek-based interventions appearing to have greater potential for improving glycemic outcomes, while guar gum may be more effective in improving lipid parameters. Since these fibers can be easily consumed in the form of dietary supplements, it is worth considering their regular, daily intake. The protocol was prospectively registered in the PROSPERO database (CRD420261368159).

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Type 2 diabetes mellitus (T2DM) is a major global health challenge that has intensified interest in multi-target nutraceuticals with potential adjunctive benefits. Ganoderma lucidum (Lingzhi/Reishi) is a medicinal mushroom traditionally used in East Asia and is increasingly investigated for its role in glycemic regulation and metabolic disturbances. This review critically synthesizes current evidence on its hypoglycemic effects, focusing on bioactive compounds, molecular mechanisms, and translational limitations. Unlike broader reviews on Ganoderma bioactivity and health-related benefits, this review specifically evaluates the alignment between taxonomic authentication, chemical standardization, preclinical mechanisms, and human clinical evidence in the context of glycemic regulation. This narrative review was based on a targeted literature search conducted in PubMed/MEDLINE, Web of Science, and Scopus for studies published up to October 2025, supplemented by Google Scholar. The included studies comprised in vitro experiments, in vivo animal models, and human clinical trials evaluating glycemic and metabolic outcomes of Ganoderma preparations. In vitro and animal studies indicate that polysaccharides, including β-(1→3)/(1→6)-glucans and proteoglycans such as FYGL, may improve insulin sensitivity via AMPK (AMP-activated protein kinase) and PI3K/Akt pathways, promote GLUT4 (glucose transporter type 4) translocation, suppress hepatic gluconeogenesis, protect pancreatic β-cells, and modulate gut microbiota. In enzyme assays and preclinical models, lanostane-type triterpenoids act primarily by inhibiting α-glucosidase and α-amylase, thereby potentially reducing postprandial glucose excursions. Despite consistent preclinical evidence, clinical findings remain heterogeneous, with the largest randomized controlled trial reporting no significant glycemic benefit. Overall, Ganoderma lucidum shows strong mechanistic plausibility but insufficient clinical evidence for antidiabetic efficacy. Future research should prioritize species authentication, chemical standardization, and adequately powered clinical trials.

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