Nutr Rev. 2026 Aug 31:nuag124. doi: 10.1093/nutrit/nuag124. Online ahead of print.
ABSTRACT
CONTEXT: The global increase in diabetes incidence has been linked to dietary transitions away from traditional coarse grains. Millets-sorghum, finger millet, and pearl millet-are nutrient-dense, climate-resilient crops with fiber, minerals, and phytochemicals that may improve glycemic control. Their sustainability and nutritional profile make them promising candidates for diabetes management.
OBJECTIVE: To systematically review and meta-analyze the effect of sorghum, finger millet, and pearl millet on diabetes management using outcome indicators such as fasting blood glucose, postprandial glucose, HbA1c, and insulin index.
DATA SOURCES: A comprehensive search was conducted of the PubMed, Scopus, Embase, ScienceDirect, and ClinicalTrials.gov databases from inception to April 2025.
DATA EXTRACTION: Two reviewers independently extracted study details, including design, participant characteristics, intervention type, control foods, and outcomes. Mean and SD values for fasting, postprandial glucose, HbA1c, and incremental area under the curve (iAUC) were recorded. Where unavailable, values were calculated using standard formulas. Study quality was assessed using the Cochrane Risk-of-Bias 2 tool.
DATA ANALYSIS: Of 36 283 records identified, 20 studies met the inclusion criteria for the review and 11 for meta-analysis. Effect sizes (Cohen’s d) were pooled using a random-effects model with millet-type subgroup analysis in SPSS Statistics; publication bias was assessed with funnel plots and Egger’s test. Millet intake significantly reduced postprandial glucose iAUC (d = -2.10, P < .001), with the greatest effect being found for finger millet (d = -4.77); pearl millet also showed a significant reduction, but sorghum did not. Long-term millet intake improved fasting blood glucose levels (d = 1.05, P = .02), and 1 study reported reduced HbA1c in 75% of participants after 3 months.
CONCLUSIONS: Millet intake improved short-term indicators of blood sugar, such as postprandial glucose, and long-term indicators, namely, fasting and HbA1c. More studies are needed to confirm long-term effects. Policies supporting millet cultivation and accessibility, alongside community education on simple millet preparations, may help translate benefits into practice.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42024557062.
PMID:42672549 | DOI:10.1093/nutrit/nuag124
