**7. Conclusions**

fruits, vegetables, and dairy products as part of a regular balanced diet. However, it has to be borne in mind that the additional costs of greater diversity require a comprehensive food

The Paleolithic diet is another regimen, which has been recently discussed as a means of obtaining weight loss and control of glycemic levels. This diet, in particular, has been shown

General information provided on the diabetes diet aims at providing meals with even distributions of increased portions of vegetables, root vegetables, dietary fiber, wholegrain bread, and other whole grain cereal products, fruits and berries, and less total fat—in particular, unsaturated fats [25]. The salt intake was recommended to be kept below 6 g/day [26]. In this respect, the Paleolithic diet was described to be based on lean meat, fish, fruit, leafy and cruciferous vegetables, root vegetables, eggs and nuts, with reduced intakes of dairy products, cereal grains, beans, refined fats, sugar, candy, soft drinks, beer, and added salt [26]. The following items were recommended in limited amounts for the Paleolithic diet: eggs (≤2 per day), nuts (preferentially walnuts), dried fruit, potatoes (≤1 medium-sized per day), rapeseed or olive oil (≤1 tablespoon per day), and wine (≤1 glass per day) [26, 27]. The recommended intake of the other types of food products did not carry any restrictions and no advice was given with regard to the proportions of food categories [26, 27]. The evolutionary preference

The Paleolithic diet is known to result in significantly lower fasting plasma leptin, nonsignificantly lower fasting plasma glucagon concentrations as well as gain weight loss, compared with a standard diabetes diet [28–30]. However, the small sample size in studies such as those by Eaton et al. [27] makes it impossible to perform adjusted multivariate analysis. Overall, long-term and adequately powered trials investigating the effects of Paleolithic diet

The importance of microbiota in the incidence of diabetes has been a recently discussed development. The gut microbiota has been hypothesized to be a link between environmental factors and the development of autoimmunity and diabetes [31]. The first gut microbiota composition is mostly acquired at birth, while the delivery mode determines the type of microorganisms that will colonize the newborn gut. After delivery, the diet is one of the main factors affecting the composition of infant gut microbiota. The diet provides substrates and sources of bacterial contamination from breast and nipple skin to breastfed babies [31]. Diet also con-

In several studies, it was found that the age, dietary patterns, geography, traditions, and culture were the main determinants explaining the differences in gut microbiota composition

to be more satiating per calorie compared to the diabetes diet [24, 25].

and rationale for the Paleolithic diet has been highlighted in Eaton et al. [27].

tributes indirectly toward the regulation of intestinal and pancreatic health.

pricing strategy as well [19].

6 Diabetes Food Plan

**5. The Paleolithic diet**

are warranted.

**6. Diet and the microbiota**

A multicomponent-based lifestyle enabling the prevention of diabetes, which includes diet and both aerobic and resistance exercise training, is generally regarded as the most effective in inducing weight loss and improving impaired fasting glucose, glucose tolerance, dietary, and exercise outcomes in at-risk and prediabetic adult populations. Several scientific studies support the current dietary and exercise guidelines for the inclusion of resistance training in type 2 diabetes prevention. However, when it comes to exercise and other physical workouts, there remains an urgent need for more rigorous studies, with long-term follow-up evaluating program efficacy, muscular fitness outcomes, diabetes incidence, and risk reduction.

Overall, a low-carbohydrate diet score has been significantly associated with a decreased risk of diabetes. This association is attenuated through adjustment of the glycemic load. The composition of the gut microbiota is also believed to be related to diabetes prevention especially since it can be modulated by diet. This modulation can promote the proper maturation of the immune system or result in gut dysbiosis and aberrant immune responses, which can eventually lead to autoimmunity and diabetes, especially in children.

People who live their lives with their diabetes are interconnected with their multilevel network and it has been observed that they adapt the illness to their life, not the opposite. In terms of the psychology of being contracted with this disease, to meet a sustainable network approach, thus involves wide encounters encompassing life factors at different levels. All social, political, and cultural factors are influential and interwoven in the dynamics, negotiations, and tensions of everyday life for people with diabetes. The impact of network on self-management of diabetes needs to be recognized and emphasized in clinical practice, as well as in the education of healthcare professionals, in research as well as in health policy to understand and respond to provide support and advice to the diabetic patients.
