Effect of Pumpkin Seed-based Dietary Intervention on Glycaemic Control among Reproductive-aged Women with Type 2 Diabetes in Sierra Leone

Abstract

Type 2 diabetes mellitus (T2DM) is a growing global health burden, particularly in low- and middle-income countries. Medical nutrition therapy is an integral component of diabetes management, and current guidance supports individualised dietary patterns that include nutrient-dense foods, such as nuts and seeds. This study evaluated a locally prepared, pumpkin seed powder-based dietary intervention among women of reproductive age with T2DM. A community-based, controlled, pretest–post-test intervention was conducted among 120 women aged 21–49 years in five communities along the Freetown Peninsula. One hundred participants received food containing 30 g of pumpkin seed powder per serving, with two servings daily (60 g/day), for 50 days; 20 participants received the same food without pumpkin seed powder. Capillary fasting blood glucose (FBG) and random/non-fasting blood glucose (RBG) were assessed at baseline and every 10 days. Longitudinal changes were evaluated using linear mixed-effects models that included group, time, the group × time interaction and study site, with participant-level random intercepts. Mean FBG declined from 8.913 to 8.708 mmol/L in the intervention group (mean change −0.205 mmol/L), compared with 8.450 to 8.420 mmol/L in the comparison group (−0.030 mmol/L). The adjusted difference in change at day 50 was −0.175 mmol/L (95% CI −0.211 to −0.139; p < 0.001). Mean RBG declined from 8.913 to 8.709 mmol/L in the intervention group (−0.204 mmol/L), compared with 8.450 to 8.415 mmol/L in the comparison group (−0.035 mmol/L), yielding an adjusted difference in change of −0.169 mmol/L (95% CI −0.203 to −0.135; p < 0.001). Reductions in the intervention group were evident from day 10 and were maintained through day 50. Standardised, pumpkin seed powder-based food was associated with modest but statistically significant improvements in FBG and RBG relative to the comparison food. These findings support further controlled trials but should not be interpreted as evidence that pumpkin seed powder can replace prescribed diabetes treatment.