Abstract
Weight loss is crucial for treating type 2 diabetes mellitus (T2DM). It remains unclear which dietary intervention is best for optimising glycaemic control, or whether weight loss itself is the main reason behind observed improvements. The objective of this study was to assess the effects of various dietary interventions on glycaemic control in overweight and obese adults with T2DM when controlling for weight loss between dietary interventions. A systematic review of randomised controlled trials (RCT) was conducted. Electronic searches of Medline, Embase, Cinahl and Web of Science databases were conducted. Inclusion criteria included RCT with minimum 6 months duration, with participants having BMI≥25·0 kg/m2, a diagnosis of T2DM using HbA1c, and no statistically significant difference in mean weight loss at the end point of intervention between dietary arms. Results showed that eleven studies met the inclusion criteria. Only four RCT indicated the benefit of a particular dietary intervention over another in improving HbA1c levels, including the Mediterranean, vegan and low glycaemic index (GI) diets. However the findings from one of the four studies showing a significant benefit are questionable because of failure to control for diabetes medications and poor adherence to the prescribed diets. In conclusion there is currently insufficient evidence to suggest that any particular diet is superior in treating overweight and obese patients with T2DM. Although the Mediterranean, vegan and low-GI diets appear to be promising, further research that controls for weight loss and the effects of diabetes medications in larger samples is needed.
Highlights
Dietary intake is recognised as a major contributor to both the development and management of type 2 diabetes(1)
Two systematic reviews have examined the effects of different dietary interventions in managing type 2 diabetes mellitus (T2DM)
Investigated the effects of low-carbohydrate, vegetarian, vegan, low glycaemic index (GI), high-fibre, Mediterranean and highprotein diets as compared with control diets
Summary
Dietary intake is recognised as a major contributor to both the development and management of type 2 diabetes(1). Investigated the effects of low-carbohydrate, vegetarian, vegan, low glycaemic index (GI), high-fibre, Mediterranean and highprotein diets as compared with control diets (low fat, high GI, low protein, and diets described as following guidelines of the ADA or European Association for the Study of Diabetes). They concluded that the Mediterranean, low-carbohydrate, low-GI and low-protein diets resulted in greater improvements in HbA1c when compared with their respective controls, with the Mediterranean diet having the greatest effect. Wheeler et al(6) conducted a systematic review that took a different approach They examined the impact of macronutrients, food groups and eating patterns on diabetes management and risk for CVD.
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