The Evolution of Biscuits for Diabetics: From Basic Snacks to Functional Foods

Diabetes occurs when the blood glucose level is higher than the normal blood glucose level (70 mg/dL). The reason behind this condition is the hormone insulin. Insulin is a hormone produced in human body by beta cells of Islets of Langerhans. This helps glucose enter inside the cells to be used for energy. In diabetes, the body either doesn’t produce enough insulin or cannot use it effectively, leading to a rise in blood glucose levels[1].

Types of diabetes:

Type 1 (Insulin Dependent Diabetes Mellitus):

In type 1 diabetes, the body produces very low amounts of insulin or excessive glucagon. This condition is usually found in children and adults. People suffering from type 1 Diabetes need insulin dose every day[2].

Type 2 (Insulin Independent Diabetes Mellitus):

In type 2 diabetes, the body’s cells develop resistance to insulin. Individuals at higher risk for type 2 diabetes often include those with a family history of the condition, as well as those who are overweight or obese. It can occur at any age[2].

Fig.1 Pathophysiology of Type 1 and Type 2 Diabetes

Diabetes is among the most frequently discussed diseases worldwide, especially in India; however, awareness remains low, as shown by the high number of diabetes patients in the country; 77 million people are suffering from diabetes in India. The WHO estimates that 80% of diabetes-related deaths take place in low- and middle-income countries., and India ranks the second highest in the world[3]. Diabetes can cause damage to the eyes, kidneys, nerves, and heart. Patients also have chances of developing some types of cancers[1].

II. Early Evolution in Diabetic Friendly Snacks:

Introduction to Early Diabetic Snacks:

By discussing the origin of diabetic-friendly snacks, particularly sweet snacks, the primary goal was to provide sugar-free alternatives to traditional high-sugar snacks. Early diabetic biscuits were typically made by replacing sugar with artificial sweeteners such as saccharin or aspartame, with minimal attention to other nutritional factors such as glycaemic index (GI), fibre content, or overall health benefits. The main focus was on removing sugar, but these biscuits often still contained refined carbohydrates (like white flour) that could spike blood glucose levels. This limited their effectiveness for true blood sugar management.

In recent years, the development of new technologies has made it possible to produce even more innovative diabetic-friendly snacks. For example, use of alternative ingredients like lentils and chickpeas to create low-carb snacks that are high in protein and fibre. These snacks help regulate blood sugar levels while also supplying essential nutrients needed for maintaining the health of individuals with diabetes. [4].

III. Introduction of Low-Glycaemic Index Ingredients

According to the National Cancer Institute Dictionary of Cancer Terms, “glycaemic index is a measure of the increase in the level of blood glucose (a type of sugar) caused by eating a specific carbohydrate (food that contains sugar) compared with eating a standard amount of glucose”[5]. Foods that contain a GI of ≤ 55 are considered low GI foods, whereas moderate GI foods have a GI ranging between 56 and 69. High GI foods have a GI of ≥ 70 [6]. Foods with a high glycaemic index cause a quick release of glucose into the bloodstream. Low-GI foods generally support weight loss, whereas high-GI foods aid in replenishing energy after physical activity or offset hypo-(insufficient) glycemia[7].A 1991 study conducted on 16 subjects with well controlled Non-Insulin Dependent Diabetes Mellitus and lipid profile showed that a low GI diet improves glucose tolerance[8]. In another study, 11 healthy men were randomly allocated to 5 weeks of a low GI or high GI diet separated by a 5-week washout interval in a crossover design. In a separate study, 11 healthy men were randomly assigned to follow either a low-GI or high-GI diet for 5 weeks, with a 5-week washout period in between as part of a crossover design. The low-GI diet resulted in reduced post-meal plasma glucose and insulin levels, as well as lower areas under the curve (AUCs)[9]. Mohammad Ishraq Zafar, et al. concluded in a systematic review and meta-analysis that low GI diets effectively reduced glycated haemoglobin (HbA1c), fasting glucose, BMI, total cholesterol, and LDL[10]. Further research on low GI diets led to the conclusion that such diets would be beneficial for the management of both type I and type II diabetes. This drove the focus of researchers and manufacturers towards developing biscuits that contained artificial sweeteners to high-fibre, high-protein,and low-fat biscuits made up of natural sugars.

Olagunju et al. developed a High-protein, low glycaemic index snack bar that elicited a low glycaemic response in diabetic human subjects. Two blends of amaranth, acha, and millet (90:5:5 and 47.98:26.68:25.34) were utilized. Of the two, the first blend showed a lower glycaemic index and higher protein content[11]. Ngaha et al. formulated biscuits with unripe banana, okra, jujube fruit, and stevia. Of the 6 flours produced, the formulation BOS2 (Banana, Okra and Stevia in the ratio of 82.5:10:7.5) recorded the lowest GI[12]. In another study conducted by Daisy Sharma, the GI of Control (made of refined wheat flour), Single Blend, and Multiple Blend Nutraceutical biscuits was compared. The flour was a blend of foxtail millet flour, flaxseed flour, and carrot flour in different ratios. Rice bran oil was used as shortening. Along with the glycaemic index, carbohydrates, proteins, beta carotene, iron, crude fibre and total mineral content were compared. It was found that single blend and multiple blend biscuits had a lower GI and were nutritionally superior than the control and hence, beneficial for diabetics[13].
Naaz et al. formulated biscuits from whole wheat flour, barley flour, soy flour, butter, salt, milk, cumin seeds, and baking powder. The flours were used in different combinations. The test sample with the greatest overall acceptability was chosen for nutritional analysis. The glycaemic load and glycaemic index of the test sample were found to be lower than that of control[14]. 

As a result of the comprehensive research in low GI foods, manufacturers introduced ingredients that reduce postprandial glucose spikes and thus had the potential to manage blood glucose levels in individuals with diabetes.

Table I enlists a few biscuits with low GI marketed in India[15].

IV. Rise of Functional Ingredients in Diabetic Biscuits

1. 1. Introduction to Functional Foods in Diabetic Biscuits

Functional foods are defined as “food items that are fortified with specific nutrients or bioactive compounds to cater to the unique needs of consumers”. These products are processed in a way that provides health benefits similar to medicine, often utilizing ingredients derived from herbs, spices, seeds, nuts, and other natural sources. The incorporation of functional ingredients aims to improve overall metabolic health, including insulin sensitivity, inflammation, and blood glucose control.

Functional foods have emerged as a promising approach to managing diabetes, going beyond the traditional focus on reducing sugar content. These innovative food products are designed to provide additional health benefits by incorporating functional ingredients that target various aspects of metabolic health[12]. The transition to functional foods represents a major progress in creating therapeutic snack options for people with diabetes.

Research indicates that functional foods can be vital in managing diabetes. Studies have explored the protective properties of various bioactive compounds present in these foods, and numerous clinical trials have validated their benefits for diabetic patients.[16]. For example, whole grains, oats, legumes, and nuts have been recognized as functional food components that can aid in regulating glycaemic response, improve insulin sensitivity, and reduce the risk of complications associated with diabetes[17], [18].

The development of functional foods for diabetics represents a significant advancement in the field of nutrition and health. By incorporating targeted functional ingredients, these products offer a more comprehensive approach to managing diabetes, addressing not only the reduction of sugar but also the improvement of overall metabolic health[12]. As research continues to uncover the potential of functional foods in diabetes management, we can expect to see more innovative and effective snack options emerge in the market.

2. Soluble Fibres for Glycaemic Control

Soluble fibres, such as psyllium husk and inulin, are becoming essential ingredients in diabetic biscuits. These fibres are advantageous as they slow carbohydrate absorption in the body, helping to prevent rapid increases in blood sugar after meals. Research has demonstrated that incorporating soluble fibre into the diet can greatly enhance blood sugar management in individuals with type 2 diabetes. A systematic review revealed that soluble fibre supplementation resulted in decreases in important blood sugar markers, such as HbA1c and fasting plasma glucose levels, indicating improved overall glycaemic control. [19], [20]. Specifically, psyllium and other viscous fibres help create a gel-like substance in the gut, which slows gastric emptying and reduces the rate at which glucose enters the bloodstream[21], [22]

In addition to helping with blood sugar levels, soluble fibres also support gut health by acting as prebiotics. This means they nourish the beneficial bacteria in our intestines, which can improve overall metabolic health. Studies have indicated that a diet high in soluble fibre is linked to better gut health and may contribute to improved glucose metabolism and lipid distribution in individuals with diabetes[19], [21, p. 20], [23].

The thickness or viscosity of soluble fibres is crucial for their effectiveness. Viscous fibres, such as psyllium, create a gel that not only slows down carbohydrate absorption but also enhances feelings of fullness, aiding in weight management[20], [22]. This makes diabetic biscuits containing these fibres more beneficial than just being sugar-free; they actively contribute to long-term glycaemic control and overall health.

Hence, incorporating soluble fibres like psyllium and inulin into diabetic biscuits enhances their health benefits beyond simply being low in sugar. By slowing carbohydrate absorption, improving insulin sensitivity, and supporting gut health, these fibres play a vital role in effectively managing diabetes. Diabetic biscuits containing these soluble fibres can be an excellent option for individuals seeking to enhance their blood sugar control and overall health.

3. Plant-Based Proteins and Antioxidants for Enhanced Benefits

Plant-based proteins, like pea protein and hemp protein, are being increasingly included in diabetic biscuits. These proteins help control stable blood sugar levels by promoting feelings of fullness and providing a slow-release source of energy. Research suggests that consuming plant-based proteins can enhance satiety, which is crucial for controlling appetite and managing weight in individuals with diabetes. For example, pea protein is noted for its high content of essential amino acids and has been shown to support muscle growth while also aiding in heart health by lowering cholesterol levels[24], [25]. Hemp protein is another beneficial addition; it is a complete protein that contains healthy fats and fibre, contributing positively to overall health[26]. Both of these proteins serve as nutritious alternatives to animal-based proteins while supporting metabolic health.

Alongside plant-based proteins, antioxidants significantly contribute to boosting the benefits of diabetic biscuits. Ingredients like polyphenols from sources such as cinnamon, turmeric, and green tea extract are recognized for their anti-inflammatory properties. These antioxidants can enhance insulin sensitivity and help decrease inflammation, which are common issues for individuals with diabetes. Research has shown that cinnamon can notably reduce fasting blood glucose levels. and enhance insulin sensitivity[25], [27] . The combination of plant-based proteins and antioxidants not only increases the nutritional value of diabetic biscuits but also addresses key health concerns linked to diabetes. By assisting in blood sugar regulation and combating chronic inflammation, these ingredients provide more comprehensive benefits than simply being sugar-free options. This makes diabetic biscuits enriched with these components a valuable choice for those aiming to manage their condition effectively.

Thus, incorporating plant-based proteins like pea and hemp protein along with antioxidant-rich ingredients into diabetic biscuits enhances their health benefits. These additions help regulate blood sugar levels, promote satiety, and reduce inflammation, making them an excellent choice for individuals managing diabetes[22], [23], [24].

4. Transformation of Diabetic Biscuits through Functional Ingredients

The formulation of diabetic biscuits has undergone a significant transformation, evolving from basic low-sugar snacks to foods that actively help manage insulin resistance, reduce inflammation, and promote overall metabolic health. This shift reflects a deeper understanding of nutrition and its impact on diabetes management [26].

Historically, diabetic biscuits primarily focused on reducing sugar content to cater to individuals with diabetes. However, recent advancements have highlighted the importance of incorporating functional ingredients that provide additional health benefits beyond just being sugar-free. For instance, the introduction of soluble fibres, plant-based proteins, and antioxidants has revolutionized these products. Soluble fibres help slow carbohydrate absorption, preventing spikes in blood sugar levels after meals[28]. Plant-based proteins enhance satiety and provide a slow-release energy source, while antioxidants improve insulin sensitivity and combat inflammation[26].

Table II highlights how the focus has shifted from merely reducing sugar to incorporating a variety of functional ingredients that support metabolic health[26], [28].

The transition from merely sugar-free snacks to functional foods represents a holistic approach to diabetes management. Instead of just avoiding sugar, manufacturers are now focusing on creating products that actively support metabolic health. This includes not only providing essential nutrients but also incorporating ingredients that help combat insulin resistance and chronic inflammation[26] .

Hence, the incorporation of functional ingredients into diabetic biscuits has transformed them into beneficial snacks that aid in managing diabetes effectively. By focusing on soluble fibres, plant-based proteins, and antioxidants, these biscuits now form an essential component of a comprehensive strategy for maintaining metabolic health rather than just being a guilt-free indulgence[28].                   

V. Current Trends in Diabetic Biscuit Formulation

The landscape of diabetes management has evolved significantly over the past few decades. We have significantly advanced from diabetic meals being merely synonymous with sugar-free options. Today, we witness a remarkable transformation, one that extends beyond blood sugar control. Current contemporary diabetic biscuits are meticulously crafted to address not only glycaemic levels but also the intricate interplay between metabolism, nutrition, and overall health.

1. Keto Friendly Biscuits:

A ketogenic diet refers to a diet that is low on carbohydrates and sugar and high in fat. This diet causes breakdown of fats into ketone molecules in the body. The free ketones act as energy source for many cells in the body[29]. Ketogenic diets popularised and proved to be beneficial for various other health related concerns in patients like weight loss, glycaemic control, and lipid profiles in overweight individuals with type 2 diabetes mellitus[30]. Biscuits were reformulated by using alternative flours like almond flour and coconut flour. The resulting biscuits have a low glycaemic index and hence are enjoyable snacks for diabetics without the worry of blood sugar spikes.

2. Fortification with Nutraceuticals:

Food manufacturers have been exploring various methods to incorporate micronutrients into everyday snacks, including biscuits, to meet and enhance their nutritional value. Fortified biscuits become an excellent snacking option as they serve as a strategic component for managing diabetes.

1. 1. Chromium:

Chromium has proven to reduce insulin irregularities, thereby reducing blood glucose levels. Individuals with type 2 diabetes often have lower levels of chromium in their blood as compared to others[31]. By incorporating chromium into biscuits, the manufacturers aim to provide an accessible source of this micronutrient.

1. 2. Magnesium:

Magnesium is a crucial nutrient for various physiological processes like metabolism and insulin sensitivity as it regulates insulin and insulin mediated glucose uptake. Type 2 diabetics are often associated with intracellular and extracellular magnesium deficiency.

Magnesium fortified biscuits can help overcome the deficiency, improve insulin resistance, and improve overall glycaemic control.

1. 3. Omega 3 Fatty Acids:

Omega fatty acids, commonly found in flaxseed and fish, are found to have strong anti-inflammatory properties[32], [33]. Chronic inflammation is found to be one of the causes of developing type 2 diabetes, as it triggers insulin resistance and other complications[34]. Including Omega 3s in biscuits provides a convenient way to incorporate an anti-inflammatory component into these biscuits and support overall health.

3. Probiotics and Prebiotics enrichment:

According to the International Scientific Association for Probiotics and Prebiotics, probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”[35]. On the other hand, the International Scientific Association for Probiotics and Prebiotics updated the definition of prebiotics as “a substrate that is selectively utilized by host microorganisms conferring a health benefit”[36]. Gut health plays a vital role in the management and prevention of diabetes, as per studies[37]. Prebiotics and probiotics help in managing and improving gut health for overall well-being. According to studies, probiotics aid in insulin sensitivity[38].There is evidence that prebiotics might help mitigate diabetes related complications.

Recent innovations in diabetic biscuits focus on probiotic and prebiotic enrichment, enhancing gut health and metabolic control. For example, formulations incorporating prebiotics like fenugreek and high-fibre ingredients promote satiety and stabilize blood sugar levels, as seen in products like Diabodelite's multi-grain cookies. Additionally, biscuits made with probiotics are emerging, aiming to improve gut microbiota, which is crucial for overall health in diabetics. These advancements reflect a shift towards functional foods that satisfy cravings and support metabolic health for individuals with diabetes. Including prebiotic and probiotic components in the biscuits will help in metabolic control, immune system health, and even diabetes management.

VI. Market Trends and Consumer Demand

Growing Demand for Functional Foods

The demand for functional foods, particularly those tailored for individuals with diabetes, has seen significant growth due to increasing consumer awareness about health and nutrition. Research indicates that consumers are becoming more health-conscious, leading to a shift in dietary preferences towards foods that not only satisfy hunger but also offer health benefits. This trend is particularly pronounced in the biscuit market, where consumers are actively searching for products that can assist in managing blood sugar levels while also offering nutritional benefits. Functional biscuits are now formulated with low glycaemic index (GI) ingredients, high fibre content, and beneficial nutrients aimed at improving overall well-being. For instance, biscuits made with whole grains, nuts, and natural sweeteners are gaining popularity as they align with the dietary needs of diabetic consumers. The incorporation of ingredients such as oats, ragi, and millets not only enhances the nutritional profile but also tackles the particular health issues related to diabetes management [15], [39].

Popular Brands and Products

Several brands have successfully capitalized on the growing market for diabetic-friendly biscuits. Notable examples include:

• Britannia Nutrichoice Essentials: These biscuits are designed specifically for diabetics, featuring a blend of ragi and oats. They are marketed as having a low glycaemic index and no added sugars, making them a safe choice for blood sugar management[15], [40].
• Diabliss Millet Cookies: Known for their nutritional richness, these cookies are low in GI and high in fibre. They utilize millet as a primary ingredient, aiding in digestion and blood glucose control[39], [41].
• Diabodelite Multi-Grain Sugar-Free Cookies: This product combines multiple grains such as oats and bajra, providing a rich source of fibre while ensuring zero trans fats. It is particularly popular among health-conscious consumers looking for tasty yet nutritious snacks[15], [39].
• Sunfeast Farmlite Digestive Cookies: These cookies are prepared with oats and almonds, providing a high protein content as well as dietary fibre. They are well-received for their taste as well as their health benefits, making them suitable for individuals managing diabetes[39], [41].

The following table summarizes the annual growth rate of functional biscuit sales, along with estimated market size in millions of dollars and key consumer trends[42], [43], [44]: