Dietary Intervention and Drug Dose Reduction in Diabetes Mellitus: A Comprehensive Literature Review

Sannu Ahmed¹, Reniya Timsina²

Keywords: Plant-based dietary intervention, glycemic control, pharmacological de-intensification, insulin dose reduction, medical nutrition therapy, type 1 and type 2 diabetes mellitus, beta cellfunction and diabetes remission, glycemic index and dietary fiber

DOI: 10.63475/yjm.v5i1.0336

DOI URL: https://doi.org/10.63475/yjm.v5i1.0336

Publish Date: 26-04-2026

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Pages: 102 - 112

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Downloads: 10

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Author Affiliation:

1 Pharmacist, National Academy for Medical Sciences, Kathmandu, Nepal
2 Health Assistant, Hemophilia Unit, Bir Hospital, Kathmandu, Nepal

Abstract

Approximately 425 million people worldwide currently have diabetes, and by 2045, that figure is predicted to rise to over 629 million. Many patients still have trouble controlling their blood sugar levels despite major advancements in treatment and the requirement to take several drugs for extended periods of time. A plant-based diet dramatically lowers the risk of diabetes, according to numerous scientific studies, effective treatment strategies like drastically altering one’s diet and lowering prescription dosages have not yet garnered much attention. This review’s objectives are to evaluate methodological quality, establish research goals, and critically synthesize the data on plant-based dietary intervention in conjunction with pharmaceutical de-intensification in type 1 (T1DM) and type 2 diabetes mellitus (T2DM). A comprehensive review of 35 sources (2001–2025), including clinical guidelines, meta-analyses, cohort studies, main intervention trials, along with a recorded T1DM case report, systematic reviews on low glycemic index (GI) diets and medical nutrition therapy, and residential and app-based dietary intervention trials, was among the primary sources. Eighty-four percent of a mixed T1DM/T2DM cohort (n = 55) achieved controlled blood glucose (≤250 mg/dL [13.9 mmol/L]) after a 72-hour plant-based intervention, while 100% of T2DM patients achieved complete glycemic control. Fifty-two percent of insulin-dependent individuals attained full pharmacological remission, and 100% of them showed an insulin dose decrease across two separate investigations. After 8 years of insulin dependence, a documented T1DM case achieved complete insulin elimination, with detectable C-peptide and negative glutamic acid decarboxylase (GAD) antibodies post-intervention; the biological basis of this finding warrants further investigation. Over the course of 3 to 12 months, low-GI eating habits lowered HbA1c by 0.3% to 0.9% and high-fiber therapies by 0.26% to 0.55% in T2DM populations. There is strong but preliminary evidence that the integrated plantbased dietary and pharmaceutical de-intensification program is a clinically significant diabetic care approach. To validate these results, rigorous multicenter randomized controlled trials with a minimum 12-month follow-up, independent replication, and thorough biochemical monitoring are desperately needed.

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