A critical review of low‐carbohydrate diets in people with Type 2 diabetes
Abstract
Aims: The efficacy of low‐carbohydrate diets (LCD) in people with Type 2 diabetes has divided the nutrition community. This review seeks to re‐examine the available data to clarify understanding. Methods: A comprehensive search of databases was used to identify meta‐analyses of LCD in Type 2 diabetes. To improve the quality of the studies analysed, the following inclusion criteria were applied: randomized control trials ≥ 4 weeks in people aged > 18 years with Type 2 diabetes; a carbohydrate intake ≤ 45% of total energy intake per day; and a dietary intake assessment at the end of the study. The resulting studies were subjected to a thematic analysis. Results: Nine meta‐analyses were identified containing 153 studies. Twelve studies met our amended inclusion criteria. There were no significant differences in metabolic markers, including glycaemic control, between the two diets, although weight loss with a LCD was greater in one study. Carbohydrate intake at 1 year in very LCD (< 50 g of carbohydrates) ranged from 132 to 162 g. In some studies, the difference between diets was as little as 8 g/day of carbohydrates. Conclusion: Total energy intake remains the dietary predictor of body weight. A LCD appears no different from a high‐carbohydrate diet in terms of metabolic markers and glycaemic control. Very LCDs may not be sustainable over a medium to longer term as carbohydrate intake in diets within studies often converged toward a more moderate level. The variable quality of studies included in earlier meta‐analyses likely explains the previous inconsistent findings between meta‐analyses.
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Long-term adherence is consistently reported as a limitation of low-carbohydrate and very-low-carbohydrate diets, particularly the latter.
“Long-term adherence is consistently reported as a limitation of low-carbohydrate and very-low-carbohydrate diets, particularly in the latter [84, 88, 89, 94].”
From Benefits of low carbohydrate diets: a settled question or still controversial? (2021) · cites this paper as [89]
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- Authors
- van Wyk, H. J., Davis, R. E., & Davies, J. S.
- Affiliations
- Department of Health Nelson Mandela Metropolitan University Port Elizabeth South Africa
- University of South Wales (GB)
- University Hospital of Wales (GB)
- ORCID
- Davies, J. S.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2015-10-18
- Volume
- 33
- Issue
- 2
- Pages
- 148-157
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2156893316
- Cited by
- 105
- References
- 34
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 12 · 2020: 13 · 2019: 24 · 2018: 19 · 2017: 13 · 2016: 6 · 2015: 1
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Nelson Mandela University Research Repository (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- low-carbohydrate diet, type 2 diabetes, glycemic control, weight loss, carbohydrate intake, very low carbohydrate diet, sustainable diets, total energy intake, metabolic biomarkers
- MeSH terms
- Energy Intake, Diabetes Mellitus, Type 2, Diet, Diabetic, Diet, Reducing, Humans, Hyperglycemia, Middle Aged, Obesity, Patient Compliance, Meta-Analysis as Topic, Reproducibility of Results, Biomarkers, Weight Loss, Overweight, Diet, Carbohydrate-Restricted, Waist Circumference
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