BMJ: Carbohydrate limiting the therapeutic effect of diet on type 2 diabetes

Dietary adjustment is an important aid to the treatment of diabetes, before the widespread clinical use of insulin, diabetics often need strict carbohydrate restriction diet.
recently conducted a systematic review and meta-analysis to examine the effects of a low-carbohydrate diet on the treatment of type 2 diabetes.
researchers collected studies from central, Medline, Embase, CINAHL, CAB and other databases as of August 2020.
assessed the efficacy and safety of a low-carbohydrate diet that lasted at least 12 weeks (LCDs, carbohydrate intake below 130g/day or less than 26% of the energy provided by carbohydrates in a diet of no more than 2000 Kcal per day) and a very low-carbohydrate diet (VLCDs, carbohydrates provide less than 10% of energy). The main endpoints of the
study were diabetes remission, defining HbA1c below 6.5% or peri-abdominal blood sugar below 7.0 mmol/L, weight loss, HbA1c levels, peritic blood sugar, and adverse events, with secondary endpoints including quality of life and laboratory bio-chemical data.
a total of 23 studies, 1357 patient data were included in this meta-analysis, and 40.6% of the studies concluded that the risk of bias was low.
study found that dietary control for six months had a higher rate of diabetes relief in the LCD population than in patients with a normal diet (HbA1c - 6.5% of patients: LCD vs normal diet group: 57% vs 31%, but in the absence of diabetes medication, the effect of THED decreased, while in the insulin-treated population, the effect was significant after LCD), but decreased when the LCD continued for 12 months.
6 months, the LCD group had a significant effect on weight loss, triglyceride reduction and increased insulin sensitivity, but decreased at 12 months.
there are reliable data showing that at 6 months, VLCD is less effective in weight loss than LCD, patient compliance may be the main factor explaining VLCD's poor effect, but for VLCD high compliance population, its weight loss effect is better than that of low compliance population.
diet control had fewer effects on patients' quality of life, adverse events, and blood lipid levels.
that a low-carbohydrate diet has a positive effect on disease control in people with type 2 diabetes, especially on the basis of appropriate drug intervention therapy.