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J Community Hosp Intern Med Perspect. 2017 Sep 19;7(4):218-221. doi: 10.1080/20009666.2017.1361293. eCollection 2017 Oct.

Use of dark chocolate for diabetic patients: a review of the literature and current evidence.

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North Florida Regional Medical Center, University of Central Florida, Gainesville, FL, USA.
Department of Medicine, Rochester Regional Health System, Rochester, NY, USA.
Department of Medicine, University of Kentucky, KY, USA.
Department of Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, Pakistan.
Department of Internal Medicine, Chandka Medical College, Larkana, Pakistan.
Department of Internal Medicine, Ziauddin Medical University Hospital, Karachi, Pakistan.


Dietary changes are a major lifestyle factor that can influence the progression of chronic diseases such as diabetes. Recently, flavanols, a subgroup of plant-derived phytochemicals called flavonoids, have gained increasing attention, due to studies showing an inverse correlation between dietary intake of flavanols and incidence of diabetes. Flavanoids in the cocoa plant may ameliorate insulin resistance by improving endothelial function, altering glucose metabolism, and reducing oxidative stress. Oxidative stress has been proposed as the main culprit for insulin resistance. The well-established effects of cocoa on endothelial function also points to a possible effect on insulin sensitivity. The relationship between insulin resistance and endothelial function is a reciprocal one. Overall, the evidence from these studies suggests that cocoa may be useful in slowing the progression to type 2 diabetes and ameliorating insulin resistance in metabolic syndrome. Additionally, results from several small studies indicate that cocoa may also have therapeutic potential in preventing cardiovascular complications in diabetic patients. Studies highlighting the potential of cocoa-containing diets, in large-randomized controlled trials should be performed which might give us a better opportunity to analyze the potential health-care benefit for reducing the risk of complications in diabetic patients at molecular level.


Cardiovascular; Dark chocolate; Nutrition; diabetes; flavanols

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