Prebiotics, Mediterranean & Plant-based diet: Effect on Gut Microbiome Diversity Glycaemic Parameters and Metabolic Markers In Prediabetic/ Type 2 Diabetic Patients. Protocol For Systematic Review. (Preprint)

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Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The prevalence of type-2 diabetes (T2D) has increased consistently and this type of diabetes is often preceded by a condition known as prediabetes (PD). The major contributor to the progression of PD to T2D is the chronic consumption of diets high in fat and carbohydrates. However, recent reports indicate that PD can be reversed through the use of different dietary interventions composed of low carbohydrate and low fat. This systematic review aims to evaluate the beneficial effects of three diets: prebiotics, Mediterranean, and plant-based diets on gut microbiota and glucose homeostasis in patients with PD/T2D Objective: This review aims to thoroughly synthesize existing literature concerning the impact of prebiotics, Mediterranean, and plant-based dietary interventions on gut microbiota composition, insulin sensitivity and glucose regulation in individuals diagnosed with prediabetes or type-2 diabetes. Methods: This review will be developed according to the 2015 PRISMA guidelines and checklist. The databases that will be used include PubMed, EBSCOhost, and Web of Science, in addition Google Scholar will be used as a search engine. We will search for studies that assessed the effect of prebiotics, Mediterranean, and plant-based dietary intervention on gut composition, glycaemic indexes and HOMA-IR values in prediabetic or type 2 diabetic patients. Studies will be screened by titles, abstracts, and keywords, followed by identifying the full-text articles. All studies that will pass the quality assessment will be included. Data extraction will be performed individually by three independent reviewers and discrepancies between them will be resolved by the fourth reviewer. To evaluate the risk of bias, the Downs and Black checklist will be used. If homogenous data is obtained then a meta-analysis will be conducted using a forest plot from the Review Manager software version 5.4 (RevMan). The strength of evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE). Results: In this study, the pre-existing literature search in the electronic databases will be collected following the publication of this protocol. Conclusions: This review will evaluate whether these dietary interventions included in this study could be effective in reversing prediabetes or preventing the development of type 2 diabetes. In addition, the obtained findings of this review will also guide future studies that can be developed to further evaluate the effectiveness of these dietary interventions on other markers associated with a leaky gut and immune function. Clinical Trial: This systematic review has been registered at the International Prospective Registry of Systematic Reviews (CRD42023478352).

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