In the past 10 years the prevalence of type 2 diabetes mel itus(T2DM) has increased hugely worldwide,driven by a rise in the numbers of overweight and obese individuals.A number of diets have been shown to be effective for the management of T2DM:the Mediterranean diet,the vegetarian diet and the low-calorie diet.Results of studies clearly indicate,however,that the efficacy of these diets is not solely related to the biochemical structure of the individual nutrients they contain.This review discusses this point with reference to the potential role of the intestinal microbiota in diabetes.The macrobiotic Ma-Pi 2 diet is rich in carbohydrates,whole grains and vegetables,with no animal fat or protein or added sugar.In shortand medium-term trials conducted in patients with T2 DM,the Ma-Pi 2 diet has been found to significantly improve indicators of metabolic control,including fasting blood glucose,glycosylated hemoglobin,the serum lipid profile,body mass index,body weight and blood pressure.The diet may also alter the gut microbiota composition,which could additionally affect glycemic control.As a result,the Ma-Pi 2 diet could be considered a valid additional shortto medium-term treatment for T2 DM. In the past 10 years the prevalence of type 2 diabetes melitus (T2DM) has increased hugely worldwide, driven by a rise in the numbers of overweight and obese individuals. A number of diets have been shown to be effective for the management of T2DM: the Mediterranean diet, the vegetarian diet and the low-calorie diet. Results of the studies clearly indicate, however, that the efficacy of these diets is not solely related to the biochemical structure of the individual nutrients that contain.This review and this point with reference to the potential role of the intestinal microbiota in diabetes. The macrobiotic Ma-Pi 2 diet is rich in carbohydrates, whole grains and vegetables, with no animal fat or protein or added sugar. short and medium-term trials conducted in patients with T2 DM , the Ma-Pi 2 diet has been found to significantly improve indicators of metabolic control, including fasting blood glucose, glycosylated hemoglobin, the serum lipid profile, body mass index, body weight and blood pressure The diet may also alter the gut microbiota composition, which could in addition affect the glycemic control. As a result, the Ma-Pi 2 diet could be considered a valid additional short to medium-term treatment for T2 DM.