Anyang Kaakyire Delphyne, Abdelfattah Omar O, Kumar Aroon, Qadeer Sami
Internal Medicine, Saint Petersburg State University, Saint Petersburg, RUS.
Internal Medicine, Heliopolis Hospital, Cairo, EGY.
Cureus. 2025 Jan 6;17(1):e77004. doi: 10.7759/cureus.77004. eCollection 2025 Jan.
This systematic review evaluates the comparative efficacy of low-carbohydrate diets (LCDs) versus low-fat diets (LFDs) in improving glycemic control, weight management, and lipid profiles in individuals with type 2 diabetes mellitus (T2DM) or prediabetes. Seven randomized controlled trials involving diverse populations were included, with dietary interventions ranging from very low-carbohydrate ketogenic (LCK) diets (typically <10% of total caloric intake from carbohydrates, with higher fat and moderate protein) to moderate carbohydrate regimens (30-45% of total calories). LFDs, in contrast, prioritized carbohydrate intake (50-60% of total calories), with reduced fat (<20-30%) and moderate protein (15-20%). Across studies, LCDs consistently demonstrated greater reductions in HbA1c, fasting glucose, and triglycerides, alongside superior weight loss and increased high-density lipoprotein cholesterol compared to LFDs. Additionally, LCDs were associated with significant reductions in diabetes medication use, highlighting their potential to decrease pharmacological dependency and improve metabolic outcomes, including enhanced insulin sensitivity and reduced inflammation. Despite variability in long-term outcomes and adherence, LCDs emerged as a promising alternative to traditional dietary approaches for managing T2DM. Further research is warranted to explore strategies to improve dietary adherence, such as behavioral interventions and technological support, and to evaluate long-term sustainability, including their effects on cardiovascular health and quality of life. These findings underscore the transformative potential of LCDs in diabetes management and highlight the need for personalized dietary approaches.
本系统评价评估了低碳水化合物饮食（LCDs）与低脂饮食（LFDs）在改善2型糖尿病（T2DM）或糖尿病前期个体的血糖控制、体重管理和血脂谱方面的比较疗效。纳入了七项涉及不同人群的随机对照试验，饮食干预范围从极低碳水化合物生酮（LCK）饮食（通常碳水化合物占总热量摄入的<10%，脂肪含量较高，蛋白质含量适中）到中等碳水化合物方案（占总热量的30 - 45%）。相比之下，LFDs优先考虑碳水化合物摄入（占总热量的50 - 60%），脂肪摄入减少（<20 - 30%），蛋白质摄入适中（15 - 20%）。在各项研究中，与LFDs相比，LCDs始终显示出糖化血红蛋白、空腹血糖和甘油三酯的更大降幅，同时体重减轻更显著，高密度脂蛋白胆固醇增加。此外，LCDs与糖尿病药物使用的显著减少相关，突出了它们降低药物依赖性和改善代谢结果的潜力，包括增强胰岛素敏感性和减轻炎症。尽管长期结果和依从性存在差异，但LCDs成为管理T2DM的传统饮食方法的有前景的替代方案。有必要进一步研究探索改善饮食依从性的策略，如行为干预和技术支持，并评估长期可持续性，包括它们对心血管健康和生活质量的影响。这些发现强调了LCDs在糖尿病管理中的变革潜力，并突出了个性化饮食方法的必要性。
