This systematic review and meta-analysis of 23 randomised controlled trials in 1357 people with type 2 diabetes demonstrated that, at 6 months, low-carbohydrate diets (LCDs; <130 g of carbohydrates per day) and very-low-carbohydrate diets (VLCDs; <50 g of carbohydrates per day) achieved 32% higher rates of remission compared with control diets (mainly low-fat). In the pooled analysis of LCDs and VLCDs, at 6 months, the number needed to treat (NNT) to achieve remission (defined as HbA1c <48 mmol/mol [6.5%]) was 3. If remission was defined as HbA1c <48 mmol/mol without glucose-lowering medication, the NNT was 20. Clinically significant improvements were also seen in weight loss, triglycerides and insulin sensitivity, without adverse consequences. Those who adhered to a VLCD also achieved significant weight loss but, overall, trials using VCLDs demonstrated lower remission rates than those using less restrictive LCDs, and this was attributed to lower adherence with the more challenging VLCDs. It was not possible to compare remission rates between VLCDs and LCDs as there were too few studies. Remission data at 12 months were sparse. Click here to read the full summary.
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