While long-term low-carbohydrate diets do not significantly improve glycated hemoglobin levels in type 2 diabetes patients, they are associated with significant improvements in high-density lipoprotein cholesterol and triglyceride levels, according to a recent meta-analysis.
The systematic review and meta-analysis evaluated the efficacy of long-term low-carbohydrate diets (LCDs) for glycemic control in patients with type 2 diabetes. The study, published in the Journal of Diabetes Investigation, analyzed data from 6 randomized controlled trials encompassing 524 participants who adhered to LCD interventions for more than 12 months.
The primary outcome was the difference in glycated hemoglobin (HbA1c) levels between the LCD and control diet groups. Secondary outcomes included changes in weight, blood pressure, and lipid profiles. The analysis demonstrated no significant difference in HbA1c levels between the long-term LCD and control groups (standardized mean difference [SMD], -0.11). Additionally, there were no significant differences in weight loss, systolic and diastolic blood pressure, or low-density lipoprotein cholesterol levels between the groups.
However, the study found that long-term LCDs were associated with a significant increase in high-density lipoprotein cholesterol (SMD, 0.22) and a decrease in triglyceride levels (SMD, -0.19) compared to control diets. While long-term LCDs may not improve glycemic control, they may provide benefits in lipid management for patients with type 2 diabetes.
Subgroup analysis comparing HbA1c levels between low-carbohydrate diets and low-fat diets showed an SMD of -0.15. For weight loss, the subgroup analysis yielded an SMD of 0.08.
Variability in adherence to long-term LCDs across studies may have influenced these findings. Differences in comparator diets among the included studies could also affect the generalizability of the results.
The meta-analysis does not support the use of long-term LCDs for glycemic control in type 2 diabetes but acknowledges their potential role in improving lipid profiles.
Full disclosures can be found in the published study.