Dietary advice for treatment of type 2 diabetes mellitus in adults
Open accessAbstract
BACKGROUND: While initial dietary management immediately after formal diagnosis is an 'accepted' cornerstone of treatment of type 2 diabetes mellitus, a formal and systematic overview of its efficacy and method of delivery is not currently available. OBJECTIVES: To assess the effects of type and frequency of different types of dietary advice for adults with type 2 diabetes. SEARCH STRATEGY: We carried out a comprehensive search of The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, bibliographies and contacted relevant experts. SELECTION CRITERIA: All randomised controlled trials, of six months or longer, in which dietary advice was the main intervention. DATA COLLECTION AND ANALYSIS: The lead investigator performed all data extraction and quality scoring with duplication being carried out by one of the other six investigators independently with discrepancies resolved by discussion and consensus. Authors were contacted for missing data. MAIN RESULTS: Thirty-six articles reporting a total of eighteen trials following 1467 participants were included. Dietary approaches assessed in this review were low-fat/high-carbohydrate diets, high-fat/low-carbohydrate diets, low-calorie (1000 kcal per day) and very-low-calorie (500 kcal per day) diets and modified fat diets. Two trials compared the American Diabetes Association exchange diet with a standard reduced fat diet and five studies assessed low-fat diets versus moderate fat or low-carbohydrate diets. Two studies assessed the effect of a very-low-calorie diet versus a low-calorie diet. Six studies compared dietary advice with dietary advice plus exercise and three other studies assessed dietary advice versus dietary advice plus behavioural approaches. The studies all measured weight and measures of glycaemic control although not all studies reported these in the articles published. Other outcomes which were measured in these studies included mortality, blood pressure, serum cholesterol (including LDL and HDL cholesterol), serum triglycerides, maximal exercise capacity and compliance. The results suggest that adoption of regular exercise is a good way to promote better glycaemic control in type 2 diabetic patients, however all of these studies were at high risk of bias. AUTHORS' CONCLUSIONS: There are no high quality data on the efficacy of the dietary treatment of type 2 diabetes, however the data available indicate that the adoption of exercise appears to improve glycated haemoglobin at six and twelve months in people with type 2 diabetes. There is an urgent need for well-designed studies which examine a range of interventions, at various points during follow-up, although there is a promising study currently underway.
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The evidence does not identify one eating plan that is clearly superior to others and that can be generally recommended for weight loss for people with diabetes.
“the evidence does not identify one eating plan that is clearly superior to others and that can be generally recommended for weight loss for people with diabetes (172).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [172]
The Discussion (page not available) says there were insufficient data to draw satisfactory conclusions when comparing different types of dietary advice, and reports no significant results for weight. This supports the absence of a clearly superior plan for adults with type 2 diabetes, but the claim extends that conclusion to people with diabetes generally. (LLM, conf=0.82)
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References 407 · Cited by 177
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- Authors
- Nield, L., Moore, H., Hooper, L., Cruickshank, K., Vyas, A., Whittaker, V., & Summerbell, C. D.
- Affiliations
- Teesside University (GB)
- University of East Anglia (GB)
- University of Manchester (GB)
- Durham University (GB)
- ORCID
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2007-07-18
- Volume
- 2010
- Issue
- 1
- Pages
- CD004097-CD004097
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC9039967
- OpenAlex
- W2132196235
- Cited by
- 177
- References
- 407
- Citations by year
- 2025: 1 · 2024: 7 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 9 · 2018: 4 · 2017: 5 · 2016: 9 · 2015: 10 · 2014: 13 · 2013: 14 · 2012: 15
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Durham Research Online (Durham University) (acceptedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- SHURA (Sheffield Hallam University Research Archive) (Sheffield Hallam University) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, dietary recommendations, dietary management, low-fat diet, low-carbohydrate diet, very low calorie diet, hypocaloric diet, physical activity, behavioral interventions, glycemic control, HbA1c, weight loss, dietary adherence
- MeSH terms
- Adult, Energy Intake, Diabetes Mellitus, Type 2, Dietary Carbohydrates, Dietary Fats, Humans, Weight Loss, Exercise, Randomized Controlled Trials as Topic, Diet, Fat-Restricted
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