Weight Loss, Glycemic Control, and Cardiovascular Disease Risk Factors in Response to Differential Diet Composition in a Weight Loss Program in Type 2 Diabetes: A Randomized Controlled Trial
Open accessAbstract
OBJECTIVE: To test whether a weight loss program promotes greater weight loss, glycemic control, and improved cardiovascular disease risk factors compared with control conditions and whether there is a differential response to higher versus lower carbohydrate intake. RESEARCH DESIGN AND METHODS: This randomized controlled trial at two university medical centers enrolled 227 overweight or obese adults with type 2 diabetes and assigned them to parallel in-person diet and exercise counseling, with prepackaged foods in a planned menu during the initial phase, or to usual care (UC; two weight loss counseling sessions and monthly contacts). RESULTS: Relative weight loss was 7.4% (95% CI 5.7–9.2%), 9.0% (7.1–10.9%), and 2.5% (1.3–3.8%) for the lower fat, lower carbohydrate, and UC groups (P < 0.001 intervention effect). Glycemic control markers and triglyceride levels were lower in the intervention groups compared with UC group at 1 year (fasting glucose 141 [95% CI 133–149] vs. 159 [144–174] mg/dL, P = 0.023; hemoglobin A1c 6.9% [6.6–7.1%] vs. 7.5% [7.1–7.9%] or 52 [49–54] vs. 58 [54–63] mmol/mol, P = 0.001; triglycerides 148 [134–163] vs. 204 [173–234] mg/dL, P < 0.001). The lower versus higher carbohydrate groups maintained lower hemoglobin A1c (6.6% [95% CI 6.3–6.8%] vs. 7.2% [6.8–7.5%] or 49 [45–51] vs. 55 [51–58] mmol/mol) at 1 year (P = 0.008). CONCLUSIONS: The weight loss program resulted in greater weight loss and improved glycemic control in type 2 diabetes.
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Weight reduction is often associated with improved insulin sensitivity and reduced risk of diabetes progression.
“weight reduction is often associated with improved insulin sensitivity and reduced risk of diabetes progression28,29.”
From Impact of digital health interventions on glycemic control and weight management. (2025) · cites this paper as [28]
The Results report greater weight loss and improved glucose and HbA1c in the intervention groups, supporting a related claim about glycemic control. The paper does not establish improved insulin sensitivity or reduced risk of diabetes progression; its participants already had type 2 diabetes. The cited copy provides section labels but no page numbers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPrescription of a low carbohydrate diet for management of T2D reduces the need for medications.
“Research evidence shows that the prescription of a low carbohydrate diet (LCD) for management of T2D improves glycaemic control, reduces the need for medications, assists with weight loss, and may improve blood lipid concentrations5–9.”
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 [7]
The Results (page not provided) report that participants in the weight-loss program were more likely than usual-care participants to reduce or discontinue diabetes medications. The paper combines the lower- and higher-carbohydrate program groups for this comparison, so it does not establish that prescribing the lower-carbohydrate diet specifically reduced medication need. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPrescription of a low carbohydrate diet for management of T2D may improve blood lipid concentrations.
“Research evidence shows that the prescription of a low carbohydrate diet (LCD) for management of T2D improves glycaemic control, reduces the need for medications, assists with weight loss, and may improve blood lipid concentrations5–9.”
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 [7]
Prescription of a low carbohydrate diet for management of T2D improves glycaemic control.
“Research evidence shows that the prescription of a low carbohydrate diet (LCD) for management of T2D improves glycaemic control, reduces the need for medications, assists with weight loss, and may improve blood lipid concentrations5–9.”
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 [7]
Low carbohydrate diets have shown efficacy in managing clinical outcomes in type 2 diabetes.
“Low carbohydrate diets (LCD) have shown efficacy in managing clinical outcomes in type 2 diabetes (T2D).”
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 [7]
Prescription of a low carbohydrate diet for management of T2D assists with weight loss.
“Research evidence shows that the prescription of a low carbohydrate diet (LCD) for management of T2D improves glycaemic control, reduces the need for medications, assists with weight loss, and may improve blood lipid concentrations5–9.”
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 [7]
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- Authors
- Rock, C. L., Flatt, S. W., Pakiz, B., Taylor, K. S., Leone, A. F., Brelje, K., Heath, D. D., Quintana, E. L., & Sherwood, N. E.
- Affiliations
- University of California San Diego (US)
- Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA
- University of Minnesota (US)
- Corresponding author
- Rock, Cheryl L.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2014-05-10
- Volume
- 37
- Issue
- 6
- Pages
- 1573-1580
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC4392939
- OpenAlex
- W2092955095
- Cited by
- 139
- References
- 39
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 8 · 2023: 15 · 2022: 8 · 2021: 6 · 2020: 21 · 2019: 14 · 2018: 11 · 2017: 17 · 2016: 11 · 2015: 8 · 2014: 2
- FWCI
- 10.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- National Cancer Institute (P30CA023100)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, weight loss, glycemic control, cardiovascular risk factors, carbohydrate intake, low-carbohydrate diet, low-fat diet, diet and exercise counseling, overweight and obesity, HbA1c, triglycerides, fasting blood glucose
- MeSH terms
- Adult, Aged, Blood Glucose, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Male, Middle Aged, Obesity, Risk Factors, Weight Loss, Case-Control Studies, Diet, Fat-Restricted, Overweight, Diet, Carbohydrate-Restricted, Young Adult, Weight Reduction Programs
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