There is low to high ( majority moderate ) certainty for small improvements of unclear clinical importance in plasma glucose , triglycerides , and HDL concentrations favoring low-carbohydrate food at half of the prespecified time points .
There was little to no difference in LDL concentration or any of the secondary outcomes ( body weight , waist circumference , blood pressure , quality of life ) in response to either of the diets ( very-low- to high-certainty evidence ) .
Conclusions Currently available data provide low- to moderate-certainty evidence that dietary carbohydrate restriction to a maximum of 40 % yields slightly better metabolic control of uncertain clinical importance than reduction in fat to a maximum of 30 % in people with T2D .
Background It remains uncertain which diet is best for people with type 2 diabetes ( T2D ) .
Objective We compared the effects of dietary carbohydrate restriction with fat restriction on markers of metabolic syndrome and quality of life in people with T2D .
Effects of a low-intensity intervention that prescribed a low-carbohydrate vs. a low-fat diet in obese, diabetic participants.
Low-carbohydrate diets have been associated with significant reductions in weight and HbA(1c ) in obese , diabetic participants who received high-intensity lifestyle modification for 6 or 12 months . This investigation sought to determine whether comparable results to those of short-term , intensive interventions could be achieved over a 24-month study period using a low-intensity intervention that approximates what is feasible in outpatient practice . A total of 144 obese , diabetic participants were r and omly assigned to a low-carbohydrate diet ( < 30 g/day ) or to a low fat diet ( < or=30 % of calories from fat with a deficit of 500 kcal/day ) . Participants were provided weekly group nutrition education sessions for the first month , and monthly sessions thereafter through the end of 24 months . Weight , HbA(1c ) , glucose , and lipids were measured at baseline and 6 , 12 , and 24 months . Of the 144 enrolled participants , 68 returned for the month 24 assessment visit .  Weights were retrieved from electronic medical records for an additional 57 participants ( total , 125 participants ) at month 24 . All participants with a baseline measurement and at least one of the three other measurements were included in the mixed-model analyses ( n = 138 ) . The low-intensity intervention result ed in modest weight loss in both groups at month 24 . At this time , participants in the low-carbohydrate group lost 1.5 kg , compared to 0.2 kg in the low-fat group ( P = 0.147 ) . Lipids , glycemic indexes , and dietary intake did not differ between groups at month 24 ( or at months 6 or 12 ) ( Clinical Trials.gov number , NCT00108459 )
There is low to high ( majority moderate ) certainty for small improvements of unclear clinical importance in plasma glucose , triglycerides , and HDL concentrations favoring low-carbohydrate food at half of the prespecified time points .
There was little to no difference in LDL concentration or any of the secondary outcomes ( body weight , waist circumference , blood pressure , quality of life ) in response to either of the diets ( very-low- to high-certainty evidence ) .
Conclusions Currently available data provide low- to moderate-certainty evidence that dietary carbohydrate restriction to a maximum of 40 % yields slightly better metabolic control of uncertain clinical importance than reduction in fat to a maximum of 30 % in people with T2D .
Background It remains uncertain which diet is best for people with type 2 diabetes ( T2D ) .
Objective We compared the effects of dietary carbohydrate restriction with fat restriction on markers of metabolic syndrome and quality of life in people with T2D .