Type 2 diabetes (T2D), formerly known as non-insulin-dependent diabetes mellitus or adult-onset diabetes mellitus, is a chronic disorder of glucose equilibrium that results from the body’s inability to make use of available insulin, along with relative insulin deficiency. T2D accounts for approximately 90-95% of all diabetes cases. Diabetes is one of the most common noncommunicable diseases and is an escalating public health problem globally. According to the International Diabetes Federation, an estimated 550 million people were living with diabetes globally in 2021. A recent study from Spain by Miguel Ruiz-Canela and colleagues, published in the Annals of Internal Medicine in August 2025, suggested that the Mediterranean diet (MedDiet) reduced the risk of T2D by 31% when combined with calorie control and exercise.
The study by Ruiz-Canela and colleagues quantified the beneficial effect of the energy-reduced MedDiet on T2D. The MedDiet was characterised by high intake of olive oil, fruit, nuts, and vegetables; a moderate intake of fish and poultry; and a low intake of red meat, processed meats, and sweets. This study was a secondary analysis of the Prevención con Dieta Mediterránea-Plus randomised, single-blinded, controlled trial (2003-2011) to investigate whether the energy-reduced MedDiet plus physical activity reduced the incidence of diabetes compared with a standard MedDiet. Participants were 4,476 adults aged 55-75 years with metabolic syndrome and obesity, but no cardiovascular disease or diabetes. Participants were randomly assigned 1:1 to intervention and control groups. The intervention group received a diet that was 600kcal per day lower compared to the control group and engaged in increased physical activity. At a median six-year follow-up, the incidence of diabetes was 31% lower in the energy-reduced MedDiet plus exercise group compared with the control group. The energy-reduced MedDiet plus exercise group also had lower dropout (better adherence to the regimen), higher physical activity levels, and a greater reduction in weight.
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The prevalence of diabetes is expected to increase due to the ageing population and the increase in the prevalence of risk factors such as obesity, unhealthy dietary habits, and sedentary lifestyles. According to leading data and analytics company GlobalData, the diagnosed prevalent cases of T2D in the 16 major markets (16MM: the US, France, Germany, Italy, Spain, the UK, Japan, Australia, Brazil, Canada, China, India, Mexico, Russia, South Africa, and South Korea) will increase from 245 million cases in 2025 to 262 million cases by 2028. Additionally, poorly managed diabetes leads to serious complications such as heart attack, stroke, kidney failure, leg amputation, vision loss, and nerve damage. The increasing burden of diabetes signifies the importance of implementing awareness programmes about healthy food such as the MedDiet, as well as calorie control, physical activity, and screening programmes on a large scale, which would help to reduce the risk of diabetes in the population.
