Evaluating recent evidence from low carbohydrate diet in type 2 diabetes management: A systematic review and meta-analysis
Vivien O Orede, Gunter Kuhnle
Type 2 diabetes is epidemic worldwide and estimated to have affected about 415 million people today. The ideal dietary strategy for managing the diseases remains uncertain among researchers and health professionals. The objective of this review is to provide an overview of recent evidence while investigating the suitability and sustainability of low carbohydrate diets (foods containing approximately 50-130g of carbohydrate) in managing type 2 diabetes. A literature search was conducted considering randomised controlled trials (RCTs) of 6 months and above to explore the effect of low carbohydrate diet in treating type 2 diabetes with a meta-analysis. The mean difference for the changes in glycated haemoglobin (HbA1c) was used to measure treatment effects according to random effects analysis. Subgroup analysis by trial duration was conducted to discover the reason for the observed level of significance. The threshold for a statistical significance was p<0.05. Five studies consisting of 496 participants in total were included in the review. A meta-analysis of the various studies reviewed showed no significant change in HbA1c reduction (I2 =0.0%, p =0.634), but saw a statistical significance in adherence to low carbohydrate diets (I2=99.4%, p<0.001) signifying reduced energy intakes from carbohydrates. Subgroup analysis showed a significant reduction in HbA1c within 6 months. Overall, there was no significant difference in HbA1c in respective of good adherence to low carbohydrate diets. These findings are consistent with other meta-analyses which have shown good adherence to restricted carbohydrate and a short-term benefit of low-carbohydrates on glycemic index control.