Depok, August 12th, 2023. dr. Witri Ardini, M.Gizi, SpGK., Doctoral Program in Nutrition, Faculty of Medicine (FK) Universitas Indonesia (UI) conducted research on specific diets for people with prediabetes that are adjusted to their genetic factors. She developed specific dietary recommendations for preventing the development of prediabetes into diabetes, based on an analysis of the interaction of nutrient intake in Indonesian society with eight genetic variants related to insulin resistance, body composition, and food preferences.
Prediabetes is a condition where blood sugar levels increase from normal values but do not meet the criteria for diagnosing diabetes. In other words, prediabetes is a transitional state from being healthy before becoming diabetes. One of the important pillars in preventing prediabetes from turning into diabetes is setting a diet. The diet that is currently considered good for preventing diabetes is a diet with plant-based ingredients (vegetarian) and the Mediterranean diet.
In addition, dr. Witri also said that there are two factors that can influence the progression of prediabetes to diabetes, namely factors that can be changed, such as lifestyle and diet, and factors that cannot be changed, such as age, gender, and genetics that are passed down from parents. There are more than 250 genetic variants – known as single nucleotide polymorphism (SNP) – which have been studied and are known to play a role in the course of diabetes and its risk factors.
SNPs are small variations in DNA that occur when one nucleotide (the building block of DNA) in a DNA sequence is replaced by a different nucleotide. These variations affect human physiological functions, for example energy metabolism becomes slower, the amount of enzymes produced decreases, the binding capacity of receptors decreases, or hormones do not function properly. As a result, depending on the SNP variant that is owned, an individual may be more susceptible or at risk of suffering from a certain disease compared to other individuals.
In Indonesia, there has not been much research on the role of genetic variation in the development of prediabetes and diabetes as well as research on the effects of diet and its interaction with genetic factors on diabetes. On the other hand, genetic profile examination services along with dietary recommendations have begun to be offered directly to the public. However, this dietary recommendation is not fully consistent with the results of an analysis of Indonesian dietary intake.
Research then conducted by dr. Witri to 193 people with prediabetes and 376 healthy people aged 20-55 years. From this study, a significant association was found between genetic variation LEPR rs1137101 (SNP encoding leptin receptors, a substance in the body associated with satiety) and GCKR rs780094 (SNP encoding a protein regulating glucose metabolism) with prediabetes. This means that there are certain variants in these two SNPs which, if owned by an individual, the risk of experiencing prediabetes will be greater.
Analysis of the nutritional intake of research subjects showed that people with prediabetes had high-risk patterns of nutrient intake, namely tending to excess energy intake, higher proportions of carbohydrates, fats and saturated fatty acids, lower fiber intake, and higher DII scores (Dietary Inflammatory Index, a number that describes a diet based on its potential for inflammation). The interaction between risky genetic variants and risky nutrient intake patterns will increase the risk of prediabetes progression.
“Thus, to prevent the development of prediabetes into diabetes in individuals who have high-risk genetic variants, specific dietary recommendations are given that are different from individuals without high-risk genetic variants. This study resulted in specific dietary recommendations for 8 high-risk genetic variants of prediabetes,” said dr. Witri.
Through his research entitled “Development of Specific Diet Formulations Based on the Interaction of Genetic Polymorphism and Macronutrient Intake Patterns for People with Prediabetes: Study of 8 Single Nucleotide Polymorphisms (SNPs) Related to Body Composition, Insulin Sensitivity and Food Preference”, dr. Witri managed to get her doctorate in the field of Nutrition Science, on Tuesday (27/6).