Blood Glucose Control Using African Traditional Fermented Foods (ATFF)

Inclusion Criteria: Clinically diagnosed pre-diabetes (diagnosed less than 6 months ago), defined as HbA1c between 5.7% and 6.4%, Both male and female prediabetic individuals Aged between 18 and 65 years Seeking clinic services at the selected AKU-outreach facilities for at least 3 visits (including seeking services for separate reasons other than pre-diabetes for the purpose of determining affiliation) Exclusion Criteria: Currently on any of the following: glucose lowering medication (including insulin therapy) steroid therapy, immunosuppressive therapy, medication for gastric disease, warfarin or other coumarin derivates, Vitamin C or E, Iron or B12 erythropoietin antiretrovirals ribavirin dapsone Chronic use (defined as consumption of more than 3 months) of non-steroidal anti-inflammatory drugs or aspirin Individuals that have consumed antibiotics in the last month. Individuals that regularly consume fermented foods or took nutritional supplements including probiotics during the 3 months prior to screening. Regular consumption shall be defined as consuming at least 250ml of fermented foods on six days in a week. Individuals who at the time of enrolment are smokers, regularly consume alcohol (defined as having had at least 12 drinks in the past year but 3 drinks or fewer per week, on average over the past year) or are suffering from drug addiction including chronic opiate use. Individuals with a history of gastrointestinal surgery (gastrectomy, bariatric surgery, or colostomy), splenectomy or gastrointestinal malignancy. Individuals known to be: HIV+ve, suffering from blood disorders such as Reticulocytosis or any form of Anaemia (including Iron deficiency, B12 Deficiency) or Haemoglobinopathies. Pregnant or lactating, with serious organic or metabolic conditions [such as malignant disease, pancreatitis, endocarditis, liver, or severe kidney disease (serum creatinine level above the normal range or macroalbuminuria including chronic renal failure), severe pulmonary or heart disease], splenomegaly, rheumatoid arthritis, hypertriglyceridemia, in a terminal stage of illness, or experiencing acute or severe episodes of mental illness at the time of enrolment. Individuals with allergies to dairy or cereal products such as millet.