![]() Diabetes in older patients is associated with an increased risk of mortality, reduced functional status, and increased risk of institutionalization. In 2015, type 2 diabetes was the 7 th leading cause of death in the United States. Diabetes accounts for $176 billion of direct medical costs in the US, including annual per capita costs of $7900, a number 2.3 times higher than costs for adults without diabetes. Prediabetes is even more common among those aged ≥ 65 in the United States, with a prevalence of 50%. In the United States in 2011–2012, 12%–14% of adults had type 2 diabetes and 38% had prediabetes. Type 2 diabetes is a global epidemic, with approximately 422 million cases worldwide and a rapidly rising prevalence in middle- and low-income countries. Multiple potential mechanisms underlie the benefits of a plant-based diet in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron. However, the evidence does suggest that the type and source of carbohydrate (unrefined versus refined), fats (monounsaturated and polyunsaturated versus saturated and trans), and protein (plant versus animal) play a major role in the prevention and management of type 2 diabetes. Optimal macronutrient ratios for preventing and treating type 2 diabetes are controversial the focus should instead be on eating patterns and actual foods. Evidence from observational and interventional studies demonstrates the benefits of plant-based diets in treating type 2 diabetes and reducing key diabetes-related macrovascular and microvascular complications. Cohort studies strongly support the role of plant-based diets, and food and nutrient components of plant-based diets, in reducing the risk of type 2 diabetes. ![]() Plant-based diets are eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds and discourage most or all animal products. ![]() Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. ![]() The prevalence of type 2 diabetes is rising worldwide, especially in older adults. ![]()
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