The Complex Gene–Carbohydrate Interaction in Type 2 Diabetes: Between Current Knowledge and Future Perspectives

Type 2 diabetes (T2D) represents a public health problem globally, with the highest prevalence reported among older adults. While an interplay of various determinants including genetic, epigenetic, environmental factors and unhealthy lifestyle, particularly diet, has been established to contribute to T2D development, emerging evidence supports the role of interactions between nutrients or dietary patterns and genes in the pathogenesis of this metabolic disorder. The amount, and especially the type of carbohydrates, in particular, have been correlated with the risk of non-communicable chronic disease and mortality. This narrative review aims to discuss the updated data on the complex and not fully elucidated relationship between carbohydrate–gene interactions and incidence of T2D, identifying the most susceptible genes able to modulate the dual association between carbohydrate intake and risk of developing T2D. The identification of genetic polymorphisms in response to this macronutrient represents a potentially powerful target to estimate individual risk and prevent the development of T2D in the context of personalized medicine. The postulation around novel foods potentially tailored to minimize the risks of developing T2D will pave the way for a new era into food research in relation to the safeguarding of well-being status in patients affected by, or at risk for, T2D.