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Diabetes Res Clin Pract. 2018 May;139:239-252. doi: 10.1016/j.diabres.2018.02.026. Epub 2018 Mar 6.

Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: A systematic review and meta-analysis.

Author information

1
The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, NSW 2006, Australia. Electronic address: emma.sainsbury@sydney.edu.au.
2
The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, NSW 2006, Australia. Electronic address: nathalie.kizirian@sydney.edu.au.
3
The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, NSW 2006, Australia. Electronic address: Stephanie.partridge@sydney.edu.au.
4
The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, NSW 2006, Australia. Electronic address: tim.gill@sydney.edu.au.
5
The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, NSW 2006, Australia. Electronic address: Stephen.colagiuri@sydney.edu.au.
6
The University of Sydney, The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, NSW 2006, Australia. Electronic address: alice.gibson@sydney.edu.au.

Abstract

Nutrition therapy is considered a key component of diabetes management, yet evidence around the ideal macronutrient composition of the diet remains inconclusive. A systematic review and meta-analysis was performed to assess the effects of carbohydrate-restricted diets (≤45% of total energy) compared to high carbohydrate diets (>45% of total energy) on glycemic control in adults with diabetes mellitus. Six databases were searched for articles published between January 1980 and August 2016. Primary outcome was between-group difference in HbA1c change. Individual effect sizes were standardized, and a meta-analysis performed to calculate pooled effect size using random effects. 25 RCTs involving 2412 participants were included. Carbohydrate-restricted diets, in particular those that restrict carbohydrate to <26% of total energy, produced greater reductions in HbA1c at 3 months (WMD -0.47%, 95% CI: -0.71, -0.23) and 6 months (WMD -0.36%, 95% CI: -0.62, -0.09), with no significant difference at 12 or 24 months. There was no difference between moderately restricted (26-45% of total energy) and high carbohydrate diets at any time point. Although there are issues with the quality of the evidence, this review suggests that carbohydrate-restricted diets could be offered to people living with diabetes as part of an individualised management plan.

KEYWORDS:

Carbohydrates; Diabetes; Diet; HbA1c; Weight

PMID:
29522789
DOI:
10.1016/j.diabres.2018.02.026
[Indexed for MEDLINE]

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