GLUCOTYPES · Glucose variability patterns for precision nutrition in diabetes

Type 2 diabetes (T2D) has emerged as a global epidemic, impacting 1 in 10 people worldwide and causing over 114,000 deaths annually in Europe. Despite extensive research, understanding the pathogenic mechanisms driving distinct disease subtypes and how diet influences glucose homeostasis has remained elusive. This knowledge gap leaves individuals with or at high risk of T2D without effective prevention or control strategies, urging a paradigm shift in our approach. The GLUCOTYPES project brings together leading experts in nutrition, metabolic diseases, glycobiology, gut microbiome, epidemiology, and machine learning from five European countries to tackle this challenge. Our strategy capitalises on advancements in wearable technologies, molecular biology, and bioinformatics. We propose to leverage high-temporal continuous glucose monitor data to identify patterns of early glycaemic alterations, a concept we refer to as glucotypes and forms the core hypothesis of our research program. Circulating and adipose tissue glycoproteomics profiling will be used to gain molecular insights into glucotypes. Machine learning algorithms will be applied to investigate the intersection between diet and glucotypes on clinical outcomes and gain mechanistic insights into how diet and gut microbiome influence glucose homeostasis in specific glucotypes. The knowledge derived from these activities will inform a proof-of-concept precision nutrition clinical study to test the efficacy of a precision-based diet on cardiometabolic outcomes and identify markers of beneficial responses to diet. In doing so, GLUCOTYPES will come closer to understanding the divergent mechanisms that influence early glycaemic alterations and how specific diets could ameliorate these alterations. Our work will establish a foundational yet comprehensive scientific groundwork to inform future precision diabetes nutrition strategies to prevent and improve the lives of all people affected by the disease.