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The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups.

Abstract

Weight loss is crucial for treating type 2 diabetes mellitus (T2DM). It remains unclear which dietary intervention is best for optimising glycaemic control, or whether weight loss itself is the main reason behind observed improvements. The objective of this study was to assess the effects of various dietary interventions on glycaemic control in overweight and obese adults with T2DM when controlling for weight loss between dietary interventions. A systematic review of randomised controlled trials (RCT) was conducted. Electronic searches of Medline, Embase, Cinahl and Web of Science databases were conducted. Inclusion criteria included RCT with minimum 6 months duration, with participants having BMI≥25·0 kg/m2, a diagnosis of T2DM using HbA1c, and no statistically significant difference in mean weight loss at the end point of intervention between dietary arms. Results showed that eleven studies met the inclusion criteria. Only four RCT indicated the benefit of a particular dietary intervention over another in improving HbA1c levels, including the Mediterranean, vegan and low glycaemic index (GI) diets. However the findings from one of the four studies showing a significant benefit are questionable because of failure to control for diabetes medications and poor adherence to the prescribed diets. In conclusion there is currently insufficient evidence to suggest that any particular diet is superior in treating overweight and obese patients with T2DM. Although the Mediterranean, vegan and low-GI diets appear to be promising, further research that controls for weight loss and the effects of diabetes medications in larger samples is needed.

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  • Authors+Show Affiliations

    ,

    1School of Sport,Exercise and Rehabilitation Sciences,University of Birmingham,Edgbaston,Birmingham B15 2TT,UK.

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    2School of Clinical Sciences,University of Bristol,Bristol BS10 5NB,UK.

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    3Centre for Exercise,Nutrition and Health Sciences,University of Bristol,Bristol BS8 1TZ,UK.

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    4School of Psychology,University of Birmingham,Edgbaston,Birmingham B15 2TT,UK.

    1School of Sport,Exercise and Rehabilitation Sciences,University of Birmingham,Edgbaston,Birmingham B15 2TT,UK.

    Source

    The British journal of nutrition 114:10 2015 Nov 28 pg 1656-66

    MeSH

    Blood Glucose
    Diabetes Mellitus, Type 2
    Diet
    Diet, Mediterranean
    Diet, Vegan
    Glycated Hemoglobin A
    Glycemic Index
    Humans
    MEDLINE
    Obesity
    Overweight
    Randomized Controlled Trials as Topic
    Weight Loss

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    26411958

    Citation

    Emadian, Amir, et al. "The Effect of Macronutrients On Glycaemic Control: a Systematic Review of Dietary Randomised Controlled Trials in Overweight and Obese Adults With Type 2 Diabetes in Which There Was No Difference in Weight Loss Between Treatment Groups." The British Journal of Nutrition, vol. 114, no. 10, 2015, pp. 1656-66.
    Emadian A, Andrews RC, England CY, et al. The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups. Br J Nutr. 2015;114(10):1656-66.
    Emadian, A., Andrews, R. C., England, C. Y., Wallace, V., & Thompson, J. L. (2015). The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups. The British Journal of Nutrition, 114(10), pp. 1656-66. doi:10.1017/S0007114515003475.
    Emadian A, et al. The Effect of Macronutrients On Glycaemic Control: a Systematic Review of Dietary Randomised Controlled Trials in Overweight and Obese Adults With Type 2 Diabetes in Which There Was No Difference in Weight Loss Between Treatment Groups. Br J Nutr. 2015 Nov 28;114(10):1656-66. PubMed PMID: 26411958.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups. AU - Emadian,Amir, AU - Andrews,Rob C, AU - England,Clare Y, AU - Wallace,Victoria, AU - Thompson,Janice L, Y1 - 2015/09/28/ PY - 2015/9/29/entrez PY - 2015/9/29/pubmed PY - 2016/2/2/medline KW - ADA American Diabetes Association KW - Diet KW - GI glycaemic index KW - GL glycaemic load KW - LCM low carbohydrate Mediterranean KW - Systematic reviews KW - T2DM type 2 diabetes mellitus KW - Type 2 diabetes KW - Weight loss SP - 1656 EP - 66 JF - The British journal of nutrition JO - Br. J. Nutr. VL - 114 IS - 10 N2 - Weight loss is crucial for treating type 2 diabetes mellitus (T2DM). It remains unclear which dietary intervention is best for optimising glycaemic control, or whether weight loss itself is the main reason behind observed improvements. The objective of this study was to assess the effects of various dietary interventions on glycaemic control in overweight and obese adults with T2DM when controlling for weight loss between dietary interventions. A systematic review of randomised controlled trials (RCT) was conducted. Electronic searches of Medline, Embase, Cinahl and Web of Science databases were conducted. Inclusion criteria included RCT with minimum 6 months duration, with participants having BMI≥25·0 kg/m2, a diagnosis of T2DM using HbA1c, and no statistically significant difference in mean weight loss at the end point of intervention between dietary arms. Results showed that eleven studies met the inclusion criteria. Only four RCT indicated the benefit of a particular dietary intervention over another in improving HbA1c levels, including the Mediterranean, vegan and low glycaemic index (GI) diets. However the findings from one of the four studies showing a significant benefit are questionable because of failure to control for diabetes medications and poor adherence to the prescribed diets. In conclusion there is currently insufficient evidence to suggest that any particular diet is superior in treating overweight and obese patients with T2DM. Although the Mediterranean, vegan and low-GI diets appear to be promising, further research that controls for weight loss and the effects of diabetes medications in larger samples is needed. SN - 1475-2662 UR - https://www.unboundmedicine.com/medline/citation/26411958/full_citation L2 - https://www.cambridge.org/core/product/identifier/S0007114515003475/type/journal_article DB - PRIME DP - Unbound Medicine ER -