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Meta-Analysis
. 2024 Oct;15(10):1410-1421.
doi: 10.1111/jdi.14271. Epub 2024 Jul 24.

Efficacy of long-term low carbohydrate diets for patients with type 2 diabetes: A systematic review and meta-analysis

Takahiro Ichikawa  1 , Hiroshi Okada  1 , Junya Hironaka  1 , Hanako Nakajima  1 , Takuro Okamura  1 , Saori Majima  1 , Takafumi Senmaru  1 , Emi Ushigome  1 , Naoko Nakanishi  1 , Masahide Hamaguchi  1 , Erina Joo  2 , Kenichiro Shide  2 , Michiaki Fukui  1
Affiliations
Meta-Analysis

Efficacy of long-term low carbohydrate diets for patients with type 2 diabetes: A systematic review and meta-analysis

Takahiro Ichikawa et al. J Diabetes Investig. 2024 Oct.

Abstract

Aims/introduction: Efficacy of long-term low-carbohydrate diets (LCD) to improve glycemic management for type 2 diabetes remains controversial. Thus, we investigated the association between long-term LCD and glycemic control in individuals with type 2 diabetes.

Materials and methods: We searched PubMed, Embase and the Cochrane Database for articles published up to June 2023, and included randomized controlled trials conducted on LCD interventions for >12 months in adults with type 2 diabetes. Primary outcome was the difference in glycated hemoglobin between long-term LCD and control groups. Additionally, we evaluated the differences in changes in systolic and diastolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, and weight between long-term LCD and control groups.

Results: Six studies were identified and met the inclusion criteria. This study did not show significant differences in changes in glycated hemoglobin between long-term LCD and control diets (standardized mean difference -0.11, 95% confidence interval -0.33 to 0.11, P = 0.32). As with glycemic control, there were no significant differences in the changes in weight loss, blood pressure, and low-density lipoprotein cholesterol between long-term LCD and control diets. However, long-term LCD were associated with greater elevation in high-density lipoprotein cholesterol (standardized mean difference 0.22, 95% confidence interval 0.04-0.41; P = 0.02) and decrease in triglyceride (standardized mean difference -0.19; 95% confidence interval -0.37 to 0.02; P = 0.03) than that in control diets.

Conclusions: Our findings suggest efficacy of long-term LCD in treating dyslipidemia in individuals with type 2 diabetes, but do not recommend long-term LCD for glycemic control in the individuals.

Keywords: Low carbohydrate diet; Meta‐analysis; Type 2 diabetes.

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Conflict of interest statement

T Ichikawa received grants from Abbott Japan Co. Ltd. E Ushigome received grant support from the Japanese Study Group for Physiology and Management of Blood Pressure, the Astellas Foundation for Research on Metabolic Disorders (grant number: 4024) and Mishima Kaiun Memorial Foundation. M Hamaguchi received grants from AstraZeneca K.K., Ono Pharma Co. Ltd., Kowa Pharma Co. Ltd. Fukui M received grants from Ono Pharma Co. Ltd., Oishi Kenko inc., Yamada Bee Farm, Nippon Boehringer Ingelheim Co. Ltd., Kissei Pharma Co. Ltd., Mitsubishi Tanabe Pharma Corp., Daiichi Sankyo Co. Ltd., Sanofi K.K., Takeda Pharma Co. Ltd., Astellas Pharma Inc., MSD K.K., Kyowa Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Kowa Pharma Co. Ltd., Novo Nordisk Pharma Ltd., Sanwa Kagagu Kenkyusho CO., Ltd., Eli Lilly, Japan, K.K., Taisho Pharma Co., Ltd., Terumo Corp., Tejin Pharma Ltd., Nippon Chemiphar Co., Ltd., Abbott Japan Co. Ltd., and Johnson & Johnson K.K. Medical Co. and TERUMO CORPORATION. All authors’ grants were outside the submitted work. The other authors declare no conflict of interest.

Approval of the research protocol: N/A.

Informed consent: N/A.

Approval data of Registry and the Registration no. of the study/trial: PROSPERO database (CRD 42023453460). The protocol was accepted by PROSPERO on 16 August 2023.

Animal studies: N/A.

Figures

Figure 1
Figure 1
PRISMA flow diagram showing the study search and selection process. RCT, randomized controlled trial; SD, standard deviation.
Figure 2
Figure 2
(a) Forest plot showing the effectiveness of the association between glycated hemoglobin levels and low‐carbohydrate diets. (b) Forest plot showing the effectiveness of the association between weight loss and low‐carbohydrate diets.
Figure 3
Figure 3
(a) Forest plot showing the effectiveness of the association between systolic blood pressure and low‐carbohydrate diets. (b) Forest plot showing the effectiveness of the association between diastolic blood pressure and low‐carbohydrate diets.
Figure 4
Figure 4
(a) Forest plot showing the effectiveness of the association between low‐density lipoprotein cholesterol levels and low‐carbohydrate diets. (b) Forest plot showing the effectiveness of the association between triglyceride and low‐carbohydrate diets. (c) Forest plot showing the effectiveness of the association between high‐density lipoprotein cholesterol levels and low‐carbohydrate diets.
See this image and copyright information in PMC

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