Millets as Functional Cereals for the Management of Type 2 Diabetes Mellitus: Nutritional Composition, Mechanistic Pathways, and Clinical Evidence

Abstract

Millets are nutrient-dense functional cereals and have the potential for managing and preventing type 2 diabetes mellitus (T2DM). In comparison to refined cereals such as polished rice and wheat, millets are a good source of dietary fiber, resistant starch, minerals, vitamins, and bioactive phytochemicals. The bioactive profile, dietary fiber, and resistant starch of millets may contribute to improving metabolic health and attenuating the postprandial glycemic response. Studies have shown that millet-derived constituents modulate glucose metabolism through multiple pathways, including inhibition of carbohydrate-hydrolyzing enzymes, improvement of insulin signaling, modulation of the gut microbiota, and suppression of oxidative stress and systemic inflammation. The superior nutritional profile, low environmental footprint, and inherent climate resilience of millets further position them as a sustainable therapeutic approach amid the rising global burden of diabetes. This narrative review comprehensively examines the nutritional profile of millet varieties, the mechanistic pathways highlighting their anti-diabetic effects, clinical trial evidence, and future research directions relevant to millet integration into diabetes management strategies.