A REVIEW ON ROLE OF MILLETS IN PREVENTION AND MANAGEMENT OF DIABETES MELLITUS

It is estimated that the number of diabetics will increase by 51% in the world by 2045, from 463 million in 2019 to 700 million 2045(1) in which type 2 diabetes accounts for about 90% in total. 87% of deaths are related to diabetes occurs in low- and middle-income countries where there are few diversify staple foods. It is important to note that in addition sedentary lifestyle and obesity, type of food consumed plays an important role in diabetes. Main commodities such as refined rice, refined wheat and corn contribute up to 80% of the energy diet in developing countries.(2) Diversify basic food products and Integrate traditional foods rich in nutrients and low in glycogen in most developing countries, this is important manage and prevent diabetes. Millet and sorghum are in first place this list of basic products. This is the method used for analyzing value of millet and sorghum as main products. These are the first analyses focus on how “good for you” millet and sorghum are in terms of to reduce diabetes and compare them with rice, wheat and maize, the“Big3” among staple foods in Asia and Africa. Among these, polished rice, is essentially deficient in micronutrients, and provides 80% of energy consumed (3) in case of high rice consumption in the Nation. Lifestyle diseases, such as type 2 diabetes, are on the rise it is imperative to explore dietary solutions that include nutrition and solve major health problems. Diversify your diet by diversifying staple foods that come with nutritious and healthy foods can play a role key role in alleviating many health-related burdens.

A systematic review of 19 research articles found that millet Helps control diabetes thanks to its fiber, polyphenol and antioxidant content.(4) Millet is traditionally eaten in African and Asian countries and was later largely replaced by rice, wheat and corn. Considering nutritional needs, the increase in non-communicable health problems such as diabetes and challenges caused by climate change, it is important to be widespread are foods that fully meet health criteria, planet and farmers. Many studies have proven the effects of millet in the treatment of diabetes Improves blood sugar control, reduces fasting and after meals increases blood glucose concentration (5,6) decreases insulin index and insulin resistance, and hypoglycosylated hemoglobin (HbA1c) levels.(7-10) The glycemic index (GI) is one measure the amount of carbohydrates in food that affects the rate and extent of changes in the blood after meals glucose concentration. General dietary strategies for improvement Blood sugar control involves consuming low GI foods.(11) Fasting blood glucose is usually measured after an overnight fast and Post-meal blood sugar levels are measured at regular intervals up to 2 hours after eating. Hyperinsulinemia is associated with insulin resistance increases the risk of type 2 diabetes.(12) So, along with postprandial glucose concentrations. It is important to measure insulin levels to evaluate the ability of foods to reduce insulin resistance. In addition, long-term blood sugar control can be measured by HbA1c marker.(13) Although there is some millet-related research these results, their information is heterogeneous. therefore, it is important to collect scientific evidence to determine, does research supports the ability of millet or not, including all types and forms of processing (including cooking) that they undergo, in order to serve as millet dietary guidelines. With increasing popularity diabetes in high and low socioeconomic groups in developed and developing countries, this document is intended for the first aimed at conducting an in-depth systematic review and meta-analysis, simple descriptive statistics, and regression analysis of all studies performed to examine the gastrointestinal tract, fasting and postprandial blood sugar, insulin response and HbA1c biomarker levels in a millet-based diet. This includes: 11 types of millet, 1 type of mixed millet and many forms of millet treatments have been tested. This information will constitute scientific basis for any claims regarding millet in relation to diabetes and useful to the scientific community, nutritionists, from nutritionists to food processors and governments in developing health, nutrition and policies and programs in agriculture.(14)

The following findings are observed after a review of different Research articles and electronic database.

The effect of consuming millet-based food as compared to normal food is found that Current recommendations for type 2 diabetes include adopting a safe and nutritious diet, especially with low GI (glycemic index) starchy foods and high fiber possibly helps control post-meal hyperglycemia and reduce body weight. Low glycemic index. A diet high in carbohydrates and fiber has been shown to successfully reduce plasma cholesterol and improve glycemic control for type 2 diabetes. For people with diabetes, regular millet consumption reduces average fasting blood sugar levels by 12% and post-meal blood sugar levels by 15%. This change was so significant that researchers no longer considered these patients diabetic and classified them as pre-diabetic. Millets are a low glycemic index food due to their high fiber content, which helps prevent post-meal blood sugar spikes. When people had prediabetes, or blood sugar levels that were slightly elevated to levels not high enough for a full-blown diabetes diagnosis, millet reduced average A1C levels by 17%, enough for these people to get their sugar levels in check (15)

The glycemic index of millets as compared to wheat and rice(16)

Nutritional composition of millets:

Fiber content and its implications for glycemic control:

Millets are known for their high fiber content, an important factor that contributes to their potential benefits in preventing and controlling diabetes.(17) The fiber in millets can be classified into two types: soluble and insoluble fiber. Soluble fiber forms a gel-like substance in the digestive tract, slowing glucose absorption and promoting better blood sugar control. Insoluble fiber adds bulk to the stool, promoting good digestion and preventing constipation

Micronutrient profile and its relevance to diabetes management:

Millets have a diverse micronutrient profile including essential minerals such as magnesium, potassium, phosphorus and iron. In particular, magnesium plays an important role in glucose metabolism and insulin activity.(18) Studies have shown that magnesium deficiency is associated with an increased risk of developing type 2 diabetes.(19)The presence of these micronutrients in millets makes them possibly advantageous for individuals with diabetes.

Phytochemicals in millets and their potential health benefits:

Millet contains many different phytochemicals, including phenolics, flavonoids, and lignans. These bioactive compounds have antioxidant and anti-inflammatory properties, which may help reduce oxidative stress and inflammation, both of which are implicated in the development and progression of diabetes and its complications. Its evidence. The presence of these micronutrients in millets makes them potentially beneficial for people with diabetes

Glycemic index and glycemic load of millets:

The glycemic index (GI) is a measure of how much a food raises blood sugar levels compared to a reference food, usually glucose or white bread.(20) In general, millet has a lower GI than refined grains such as rice, wheat and corn.(21) This lower GI indicates millet is digested and absorbed more slowly, resulting in a gradual and sustained release of glucose into the bloodstream. Therefore, millet can help prevent sudden increases in blood sugar, helping to control blood sugar better. Glycemic load (GL) consider both the quality and amount of carbs in food. It determined by duplicating the GI of food by how much accessible per serving and dividing by 100. Millet, with its relatively low GI and moderate to high fiber content, typically has a higher blood sugar, lower than refined grains. This means that millet consumption can reduce post-meal blood sugar levels, thereby reducing the burden of insulin production and potentially improving glycemic control.

Role of dietary fiber in regulating blood glucose levels:

Millet is rich in fiber, which plays an important role in regulating blood sugar levels. Fiber slows down the digestion and absorption of carbohydrates for preventing glycemic level spikes. In particular, soluble fiber forms a gel-like substance in the digestive tract, slowing the emptying of the stomach and slowing the release of glucose into the blood. This more slow arrival of glucose keeps up with more steady glucose levels and advances better glycemic control. The fiber in millet also provides a feeling of fullness, promoting satiety and reducing the risk of overeating or consuming too much foods with a high glycemic index. By remembering millet for their eating routine, individuals with diabetes can more readily control their glucose levels and reducing risk of complications associated with inadequately controlled diabetes.

Effect of millet consumption on postprandial blood glucose response:

Studies have shown that including millets in meals can reduce the postprandial glycemic response, which is characterized by a slower and less pronounced rise in blood sugar after a meal. This effect is due to a combination of factors, including the low glycemic index, high fiber content, and the presence of beneficial phytochemicals in millets. By regulating the postprandial glycemic response, millet may help people with diabetes maintain more stable blood sugar levels throughout the day,  reducing the need for excessive insulin secretion and potentially improving long-term glycemic control.

Potential Mechanisms of Action:

Insulin sensitizing effects of millets:

Millet has been shown to have insulin-sensitizing properties, which may improve the effectiveness of insulin in reducing blood sugar levels.(22-24)The specific compounds responsible for these effects are still available. Its being researched, but fiber and phytochemicals found in millet are thought to play a role. Insoluble fiber found in millets can assist with further developing insulin awareness by reducing insulin obstruction and advancing better glucose absorption by cells. Additionally, certain phytochemicals found in millet, such as phenolics and flavonoids, are associated with improved insulin signaling and glucose metabolism.

Regulation of gut microbiota and its effect on glucose metabolism:

Emerging evidence suggests that the composition and activity of the gut microbiota play an important role in glucose metabolism and insulin sensitivity. Millet, with its high fiber content, acts as a prebiotic, nourishing beneficial gut bacteria.(25,26) The fermentation of millet fibers by gut microbiota produces short-chain fatty acids (SCFAs),such as butyrate, have been shown to have positive effects on glucose metabolism and insulin sensitivity. SCFAs increase the secretion of intestinal hormones that regulate appetite and blood sugar levels, and improve the integrity of the intestinal barrier. These effects contribute to improving blood sugar control and helps to prevent the onset of  diabetes.  Clinical evidence for the role of millet in preventing and treating diabetes:

Glycemic control and millet consumption:

A few clinical examinations have explored the effect of integrating millets into the eating routine on glycemic control in people with diabetes.(27-30)These studies have consistently demonstrated favorable effects on postprandial glucose levels and glycated hemoglobin (HbA1c) levels. For example, A randomized controlled trial in people with type 2 diabetes found that replacing rice chips with finger millet significantly reduced postprandial blood sugar levels over the long term compared to a control group that consumed rice. Similarly, another study found that replacing rice with millet significantly reduced HbA1c levels in people with type 2 diabetes over a three-month period. These results highlight the potential of millet.

1. International Diabetes Federation. Global Diabetes Data Report 2010–2045.Available online at: diabetesatlas.org
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