Introduction
’, hyperglycemia, cardiovascular and kidney diseasesDiet, pre-diabetic, diabetes
HYPERGLYCEMIA, PRE-DIABETES, PRE-DIABETIC, PRE-DIABETES, TYPE 2 DIABETES, DIABETES
Pre-diabetes, a condition characterized by elevated blood glucose levels but below diabetes thresholds, is a significant risk factor for the development of type 2 diabetes, as well as other comorbidities including cardiovascular and kidney diseasesDiet plays a critical role in the development of hyperglycemia and the onset of pre-diabetes. Poor nutrition high in processed meat, low-quality carbohydrates and sugary drinks, and low in plant-based foods, can lead to an inflammatory immune response that damages pancreatic beta cells and causes insulin insufficiencyThe gut microbiome is believed to play a mediating role in the relationship between diet, metabolism and immunity, by extracting energy from foods otherwise indigestible by the host and producing metabolites and cytokinesTo date, the majority of microbiome studies have focused on the level of species composition, however this approach has limitations. For example, it can create a false dependency between measured features such that one species’ abundance is dependent on another species’ measured level, even if this is not biologically true. Moreover, bacteria are genetically heterogeneous, and even two strains of the same species can differ by up to 5% in their genetic makeup, resulting in different bacterial phenotypes and effects on the host that compositional analyses may missIn this work we assess the impact of a personalized postprandial glucose-targeting diet (PPT), as well as the standard of care Mediterranean diet (MED), on the oral and gut microbiome, metabolites and cytokines in 200 pre-diabetic individuals. Our previous work has demonstrated the superiority of the PPT diet in improving glycemic status compared to the standard of care