Personalised Nutrition Approaches in the Prevention and Management of Type 2 Diabetes: A Narrative Review of Evidence and Practice.

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• People respond differently to the same foods; personalised nutrition aims to account for this variability.

• New technologies, such as glucose monitors and mobile health apps, may help tailor dietary advice more precisely. They also assist with self-monitoring and patient engagement for active health participation.

• While personalised nutrition approaches are promising, traditional healthy eating patterns remain important for preventing and managing T2D.

Introduction

The aim of this narrative review was to evaluate current evidence on personalised nutrition approaches for the prevention and management of type 2 diabetes (T2D), and to explore how individual variability (genetic, metabolic, phenotypic, behavioural and microbiome-related factors) may influence dietary responses and glycaemic outcomes.

Methods

A comprehensive, structured literature search was conducted across 3 databases and findings synthesised from 58 intervention studies, observational research, and precision nutrition trials investigating tailored dietary approaches to T2D. To ensure the inclusion of practice-based evidence, grey literature such as policy documents and technical reports from reputable organisations were also reviewed. Primary search terms were  glycaemic index, glycaemic load, food insulin index, Type 2 diabetes and personalised nutrition

Results 

• Evidence supports dietary and lifestyle measures for prevention and management of T2DM. However, responses to dietary interventions vary considerably between individuals, with genetics, gut microbiota and insulin sensitivity contributing to the variability.

• Evidence suggests that personalising dietary strategies can improve outcomes for individuals with T2DM. Studies of the low-GI and low GL diets reduced postprandial glucose spikes compared to standard dietary advice; the use of CGM data, gut microbiome profiling and algorithms improves glycaemic response; digital personalised nutrition platforms positively impact co-morbid conditions of obesity, lipid metabolism and inflammation.

• Genetic variation and nutrigenetic factors (e.g., FTO, TCF7L2, PPARG) have been used to guide personalised dietary recommendations and combined with metabolic biomarkers to refine dietary planning in T2D.

• Gut microbiome composition has been shown to influence individual glycaemic responses to identical meals and could be helpful when incorporated into personalised dietary interventions.

• Digital health technologies, including continuous glucose monitoring (CGM), may improve self-monitoring, engagement and short-term glycaemic outcomes when integrated into personalised nutrition strategies.

• Evidence supporting long-term clinical outcomes, such as sustained HbA1c reduction or diabetes remission through personalised nutrition, remains limited.

Conclusion

Personalised nutrition represents a shift from generic to tailored dietary strategies and shows promise for improving glycaemic control and engagement in T2D management. While evidence supports its potential added value over conventional approaches, challenges remain regarding scalability, cost, and real-world implementation, particularly in resource-limited settings.

• Personalised nutrition strategies may help identify individual glycaemic responses to foods, potentially improving dietary adherence and engagement.

• Use of tools such as CGM and digital platforms may support tailored dietary feedback in individuals at risk of or living with T2D.

• Traditional risk factors (body mass index, family history, metabolic markers) remain central in assessment, with genetic data currently offering limited additional predictive value.

• Clinicians may consider integrating behavioural and lifestyle data when tailoring dietary advice rather than relying solely on standardised guidelines.

• Personalised nutrition approaches may complement, rather than replace, established evidence-based dietary patterns for T2D prevention and management.

• Large, long-term randomised controlled trials are needed to determine whether personalised nutrition results in sustained improvements in HbA1c, diabetes prevention, and remission outcomes.

• Further research should focus on real-world implementation, scalability, feasibility, and cost-effectiveness of personalised nutrition models within existing healthcare systems.

• Additional studies are needed to better understand the incremental value of genetic and microbiome-informed approaches alongside established clinical and behavioural predictors.

• Research should examine accessibility and equity considerations to ensure personalised nutrition approaches are applicable across diverse socioeconomic and cultural settings.