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International Journal of Bioprinting 3D-printed diabetic diet

International Diabetes Federation (IDF), approximately visually appealing presentation, and personalized
451 million adults worldwide were affected by diabetes in nutrition. At the same time, 3D-printed food can
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2017, and the figure is projected to rise to 693 million by potentially improve oral intake and nutritional needs
2045 if effective prevention measures are not implemented. of patients, as 3D printing technology is able to create
2
Diabetes can give rise to long-term complications, such as personalized food that meets the dietary need of
retinopathy, neuropathy, kidney disease, hypertension, consumers. For instance, significant efforts have been
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and abnormal lipoprotein metabolism, which, if directed toward the 3D printing of soft-textured and safe-
left unmanaged, potentially lead to life-threatening to-swallow food for patients with dysphagia. In addition,
3
complications, organ failure, and death. the enhanced visual appeal displayed by the 3D-printed
The American Diabetes Association advocates the Diabetes food can improve food intake, thereby preventing
Plate method as a straightforward way of maintaining a malnutrition among patients. Additionally, 3D printing
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healthy diet to manage blood glucose level. This approach has been employed to produce meat substitute, such as a
4,5
has demonstrated effectiveness in improving glycemic soybean oil-based functional emulsification gel, with the
control among individuals with diabetes. Moreover, aim of enhancing the lipid profile and reducing saturated
alternative guidelines, such as the European or Canadian fat content in the food. In a similar vein, ground larvae
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recommendations, which suggest the consumption of of yellow mealworms (Tenebrio molitor) have been
45–60% of total energy from carbohydrates, 10–20% 3D-printed into snacks, providing a novel protein source
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from protein, and less than 35% from fat, were also with a high content of total essential amino acid. Other
widely practiced. 6 alternative protein sources, such as black soldier fly larva,
The aforementioned guidelines are effective and user- cricket powder, and sericin, have also been demonstrated
friendly. Nevertheless, diabetic patients who suffer from to be suitable for 3D food printing. 21
additional complications, such as kidney conditions or The 3D printing of food items with a soft texture
oral ulcers, require specific dietary considerations. As one and personalized nutrition holds promise for improving
of the most prevalent complications of diabetes, chronic nutrition intake and alleviating pain among diabetic
kidney disease (CKD) affects 30% and 40% of patients patients with oral ulcers. This study focuses on formulating
with types 1 and 2 diabetes, respectively. In light of this, 3D-printable food inks using natural ingredients that
the 2020 National Kidney Foundation Kidney Disease have established benefits for oral health and diabetes
Outcomes Quality Initiative Clinical Practice Guidelines management. We have carefully selected natural food
for Nutrition in CKD recommend that daily protein intake ingredients such as wheat bran, milk powder, and
(DPI) be adjusted to 0.6–0.8 g/kg of ideal body weight per mushrooms. The ample cereal polyphenols found in
day for diabetic patients with stages 3–5 CKD. Patients wheat bran can exert protective effects to enhance diabetes
7
with CKD experience renal function decline, and a low- management through multiple pathways. These pathways
protein diet has been shown to exert renal protective effects include reducing oxidative stress and AGEs production,
by reducing intraglomerular pressure and improving inhibiting inflammation, and regulating gut microbiota. 22-25
glomerular hyperfiltration or hypertension. Furthermore, Milk powder 26,27 and mushrooms 28,29 are both rich in B
8
evidence suggests that diabetic patients have more complex vitamins, which promote the healing of canker sores.
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oral conditions than non-diabetic individuals and grapple Additionally, numerous studies have demonstrated the
with a higher risk for oral mucosal diseases. 9-12 Recurrent beneficial effects of mushrooms in diabetes control. 30-32
oral ulcer is the most common ulcerative condition among The content of fiber and resistant starch is crucial in
oral mucosal diseases. While the prevalence of recurrent food ink formulation. 33,34 The rheological properties,
oral ulcer in the general population is approximately textures, microstructures, and composition of the food
20%, it stands at an extremely high level, as high as inks are subsequently characterized. Customized diets
9,13
45%, in diabetic patients. Although oral ulcers are not can be created from these raw ingredients utilizing
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life-threatening, pain and discomfort that come with 3D printing technology, incorporating functional
them diminish quality of life and work efficiency among compounds that alleviate the symptoms of oral ulcers
the affected individuals. Therefore, facilitating the healing and other complications of diabetes while providing
process of oral ulcers is crucial for improving the quality of nutrients in balanced proportions. In this study, animal
life of diabetic patients. 15 experiments were conducted to assess the effectiveness of

Three-dimensional (3D) printing is considered a the 3D-printed diet in glycemic control. The utilization of
prominent digital manufacturing technology within the dual-nozzle collaborative 3D printing technology enables
realm of Industry 4.0, offering the ability to reconstruct precise regulation of the nutritional composition, a crucial
food items equipped with improved structural properties, aspect for CKD patients requiring protein-restricted diets.

Volume 10 Issue 2 (2024) 297 doi: 10.36922/ijb.1862