Hironaka Junya, Hamaguchi Masahide, Ichikawa Takahiro, Nakajima Hanako, Okamura Takuro, Majima Saori, Senmaru Takafumi, Okada Hiroshi, Ushigome Emi, Nakanishi Naoko, Joo Erina, Shide Kenichiro, Fukui Michiaki
Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto, Japan.
J Diabetes Investig. 2024 Dec;15(12):1753-1762. doi: 10.1111/jdi.14326. Epub 2024 Oct 3.
Despite the reported success of low-carbohydrate diets in improving glycemic control in the Western countries, no studies have investigated the effects of such diets in Asians. We aimed to conduct a systematic review and meta-analysis of randomized controlled trials to examine the effects of low-carbohydrate diets on glycemic control in East Asian adults.
We systematically searched the PubMed, Cochrane Library, and Embase databases from inception to June 28, 2023, to identify randomized controlled trials examining the efficacy of low-carbohydrate diets in patients with type 2 diabetes (PROSPERO number CRD 42023453007). The primary outcome was the difference in glycated hemoglobin levels between the low-carbohydrate diet and control groups. The secondary outcome was the difference in body mass index, fasting blood glucose level, blood pressure, and lipid profile.
Six randomized controlled trials met the eligibility criteria. The study duration ranged from 3 to 18 months, with five studies conducted within 6 months. The results showed that low-carbohydrate diets were more beneficial in lowering glycated hemoglobin levels and body mass index than control diets. The risk of bias for the six studies was minimal for two and moderate for four. The heterogeneity among the studies was low.
Low-carbohydrate diets improved glycated hemoglobin levels and body mass index in East Asians compared with control diets. Therefore, carbohydrate restriction may be effective for glycemic management in East Asians with type 2 diabetes for at least 6 months.
尽管有报道称低碳水化合物饮食在西方国家改善血糖控制方面取得了成功，但尚无研究调查此类饮食对亚洲人的影响。我们旨在对随机对照试验进行系统评价和荟萃分析，以研究低碳水化合物饮食对东亚成年人血糖控制的影响。
我们系统检索了从数据库建立至2023年6月28日的PubMed、Cochrane图书馆和Embase数据库，以确定研究低碳水化合物饮食对2型糖尿病患者疗效的随机对照试验（国际前瞻性系统评价注册库编号CRD 42023453007）。主要结局是低碳水化合物饮食组和对照组之间糖化血红蛋白水平的差异。次要结局是体重指数、空腹血糖水平、血压和血脂谱的差异。
六项随机对照试验符合纳入标准。研究持续时间为3至18个月，其中五项研究在6个月内完成。结果表明，与对照饮食相比，低碳水化合物饮食在降低糖化血红蛋白水平和体重指数方面更有益。六项研究中两项的偏倚风险最小，四项为中度。研究之间的异质性较低。
与对照饮食相比，低碳水化合物饮食改善了东亚人的糖化血红蛋白水平和体重指数。因此，碳水化合物限制可能对东亚2型糖尿病患者的血糖管理有效，至少持续6个月。
