A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
Open accessAbstract
Background/objectives: In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges of accessibility and availability of dietary education and support for T2DM. No previous study had evaluated a web-based LCD intervention using a randomised controlled trial (RCT) design. The objective of this study was to assess whether a web-based LCD programme provided in conjunction with standard care improves glycaemic control in adults with T2DM. Subjects/methods: A 16-week parallel RCT was conducted remotely during Covid-19 among the general community, recruiting adults with T2DM not on insulin aged 40–89 years. Participants were randomly assigned (1:1) to standard care plus the web-based T2Diet healthy LCD education programme (intervention) or standard care only (control). The primary outcome was haemoglobin A1c (HbA1c). Secondary outcomes were weight, body mass index (BMI), anti-glycaemic medication, dietary intake, and self-efficacy. Blinded data analysis was conducted by intention-to-treat. Results: Ninety-eight participants were enrolled, assigning 49 to each group, with 87 participants (n = 40 intervention; n = 47 control) included in outcome analysis. At 16 weeks, there was a statistically significant between-group difference favouring the intervention group, with reductions in HbA1c –0.65% (95% CI: –0.99 to –0.30; p < 0.0001), weight –3.26 kg (p < 0.0001), BMI –1.11 kg/m 2 (p < 0.0001), and anti-glycaemic medication requirements –0.40 (p < 0.0001), with large effect sizes Cohen’s d > 0.8. Conclusion: This study demonstrated that as an adjunct to standard care, the web-based T2Diet programme significantly improved glycaemic control and clinical outcomes in adults with T2DM. In addition, the results highlight the potential to improve access and availability for people with T2DM to achieve glycaemic control and improved health through web-based dietary education and support.
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The average reduction in HbA1c in the T2Diet study trial (−0.6%) was less than the improvement recorded in the current trial (−1.0%), providing further support for the use of LCD apps within the Australian health care system.
“While the average reduction in HbA1c in the T2Diet study trial (−0.6%) was less than the improvement recorded in the current trial (−1.0%), this provides further support for the use of LCD apps within the context of the Australian health care system.”
From mHealth low carbohydrate dietary intervention ameliorates glycaemic profile, blood pressure and weight status in people with type 2 diabetes (2025) · cites this paper as [34]
The Discussion and Results report an approximately −0.6% HbA1c effect for T2Diet, but this is the difference between the intervention and control groups (−0.65%). The intervention group's average reduction was −0.94%, so calling −0.6% the trial's average reduction conflates the two measures. The comparison with the citing authors' current trial is their own, not a finding attributed to T2Diet. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe T2Diet study found that over a 4-month period, those provided with the web-based LCD intervention in combination with standard care significantly reduced HbA1c by 0.6%, body weight by 3.3 kg, BMI 1.1 kg/m2 and the use of diabetes medications, compared to those receiving standard care alone.
“Irrespective of these differences, the T2Diet study found over a 4 month period those provided with the web based LCD intervention in combination with standard care, significantly reduced HbA1c by 0.6%, body weight by 3.3 kg, BMI 1.1 kg/m2 and the use of diabetes medications, compared to those receiving standard care alone34.”
From mHealth low carbohydrate dietary intervention ameliorates glycaemic profile, blood pressure and weight status in people with type 2 diabetes (2025) · cites this paper as [34]
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Self-citation
- Authors
- Dening, J., Mohebbi, M., Abbott, G., George, E. S., Ball, K., & Islam, S. M. S.
- Affiliations
- Deakin University (AU)
- Corresponding author
- Dening, Jedha
- ORCID
- Venue
- Nutrition & Diabetes
- Published
- 2023-08-27
- Volume
- 13
- Issue
- 1
- Pages
- 12-12
- ISSN
- 2044-4052 (ISSN-L)
- PMC
- PMC10460437
- OpenAlex
- W4386188057
- Cited by
- 31
- References
- 41
- Citations by year
- 2026: 5 · 2025: 17 · 2024: 8 · 2023: 1
- FWCI
- 5.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nutrition and Diabetes (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Deakin University
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, low-carbohydrate diet, glycemic control, HbA1c, nutrition education, body mass index, self-efficacy, COVID-19 pandemic
- MeSH terms
- Internet-Based Intervention, Glycemic Control, COVID-19, Adult, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Diet, Carbohydrate-Restricted
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