The impact of major dietary patterns on glycemic control, cardiovascular risk factors, and weight loss in patients with type 2 diabetes: A network meta‐analysis
Abstract
Objective: To comprehensively compare the differences between major dietary patterns in improving glycemic control, cardiovascular risk, and weight loss for patients with type 2 diabetes. Method: We systematically searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials (RCTs) that compared the efficacy of Mediterranean, low‐carbohydrate, and/or low‐fat dietary patterns for patients with type 2 diabetes. Studies that compared any one of those diets with regular diet were also included. The risk of bias in eligible RCTs was evaluated according to the Cochrane Handbook. The primary outcome was glycemic control. Secondary outcomes included weight loss and cardiovascular risk factors. A network meta‐analysis was performed using R‐3.3.2. Results: Ten RCTs involving five dietary patterns met the eligibility criteria. The findings revealed that compared to low‐fat diet, Mediterranean diet showed beneficial effects in glycemic control (HbA1c [%]: MD = –0.45, 95% CI = –0.55 to –0.34; fasting plasma glucose [mmol/L]: MD = –1.24 95% CI = –1.57 to –0.91, respectively; weight loss [kg]: MD =–1.18, 95% CI = –1.99 to –0.37; waist circumference [cm]: MD = –0.73, 95% CI = –1.26 to –0.19), and cardiovascular risk factors (HDL‐cholesterol [mmol/L]: MD = 0.07, 95% CI = 0.04 to 0.11; total cholesterol [mmol/L]: MD = –0.17, 95% CI = –0.26 to –0.08; triglycerides [mmol/L]: MD = –0.21, 95% CI = –0.27 to –0.16). Network meta‐analysis showed that high‐carbohydrate diet improved HDL‐cholesterol (mmol/l) (MD = 1.04, 95% CI = 0.39 to 1.68) when compared with regular diet. The differences were not statistically significant in other indirect comparison groups for other outcomes. Conclusions: A mediterranean diet showed beneficial improvements in glycemic control, weight loss, and cardiovascular risk factors in people with type 2 diabetes.
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In the USA, total spending on epilepsy reached 12.5 billion dollars, of which 85% are not directly related expenses.
“In the USA, the total spending on this disease reached 12.5 billion dollars, of which 85% is the not directly related expenses.”
From State of the Art and Challenges in Epilepsy—A Narrative Review (2023) · cites this paper as [34]
For people with epilepsy, costs include days lost from work and school, unemployment, social isolation, poor social life, and minimal emotional and financial support.
“For these people, these costs are also countable in days lost from work and school, unemployment, social isolation, poor social life, and minimal emotional and financial support [34].”
From State of the Art and Challenges in Epilepsy—A Narrative Review (2023) · cites this paper as [34]
One meta-analysis used a network method to consider both direct and indirect comparisons between multiple diets.
“One meta-analysis used a network method to consider both direct and indirect comparisons between multiple diets (Mediterranean diets, low-carbohydrate diets [LCDs], low-fat diets [LFDs], high-carbohydrate diets and usual diets) [25].”
Most meta-analyses were of critically low (n = 7) to low quality (n = 5).
“Most meta-analyses were of critically low (n = 7; [25–31]) to low quality (n = 5; [32–36]).”
A network meta-analysis reported that Mediterranean diets were marginally more effective than LFDs for weight loss (−1.2 kg; 95% CI −1.99, −0.37; four RCTs, low quality; p-heterogeneity = 0.08).
“A network meta-analysis also reported that Mediterranean diets were marginally more effective than LFDs for weight loss (−1.2 kg; 95% CI −1.99, −0.37; four RCTs, low quality; p-heterogeneity = 0.08; ESM Table 12) [25].”
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Mediterranean Diet and Obesity-related Disorders: What is the Evidence?
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“For these people, these costs are also countable in days lost from work and school, unemployment, social isolation, poor social life, and minimal emotional and financial support [34].”
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- Authors
- Pan, B., Wu, Y., Yang, Q., Ge, L., Gao, C., Xun, Y., Tian, J., & Ding, G.
- Affiliations
- Lanzhou University (CN)
- Lanzhou University Second Hospital (CN)
- Corresponding author
- Ding, Guowu
- Venue
- Journal of Evidence-Based Medicine
- Publisher
- Wiley
- Published
- 2018-08
- Volume
- 12
- Issue
- 1
- Pages
- 29-39
- ISSN
- 1756-5383 (ISSN-L)
- 1756-5391
- OpenAlex
- W2886474148
- Cited by
- 99
- References
- 62
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 20 · 2023: 14 · 2022: 19 · 2021: 12 · 2020: 12 · 2019: 7
- FWCI
- 7.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Evidence-Based Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Lanzhou University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, Mediterranean diet, low-carbohydrate diet, low-fat diet, high-carbohydrate diet, dietary habits, glycemic control, HbA1c, fasting blood glucose, weight loss, waist circumference, cardiovascular risk factors, HDL cholesterol, total cholesterol, triglycerides, lipid profile, diet comparison, indirect comparison, risk of bias
- MeSH terms
- Network Meta-Analysis, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Dietary Fats, Glycated Hemoglobin, Humans, Cholesterol, HDL, Risk Factors, Triglycerides, Weight Loss, Randomized Controlled Trials as Topic, Diet, Mediterranean, Waist Circumference
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