Effectiveness of low-carbohydrate diets on type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials in Eastern vs. Western populations
Issued Date
2025-11-01
Resource Type
ISSN
01688227
eISSN
18728227
Scopus ID
2-s2.0-105015396117
Journal Title
Diabetes Research and Clinical Practice
Volume
229
Rights Holder(s)
SCOPUS
Bibliographic Citation
Diabetes Research and Clinical Practice Vol.229 (2025)
Suggested Citation
Mongkolsucharitkul P., Surawit A., Pimsen A., Winitchayothin S., Pumeiam S., Pinsawas B., Ophakas S., Suta S., Pasookhush P., Mayurasakorn K. Effectiveness of low-carbohydrate diets on type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials in Eastern vs. Western populations. Diabetes Research and Clinical Practice Vol.229 (2025). doi:10.1016/j.diabres.2025.112464 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112091
Title
Effectiveness of low-carbohydrate diets on type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials in Eastern vs. Western populations
Author's Affiliation
Corresponding Author(s)
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Abstract
Aims: Low-carbohydrate diets (LCDs) have emerged as a potential dietary intervention for managing glycemic control, but their effectiveness across different cultural contexts remains unclear. To evaluate the efficacy of LCDs in managing type 2 diabetes, with attention to cultural context, and to clarify how variability in carbohydrate definitions affects interpretation. Methods: We searched PubMed, Embase, and Scopus from inception to 1 August 2024 for randomized controlled trials (RCTs) ≥ 12 weeks in adults with type 2 diabetes. We conducted exploratory analyses by Eastern versus Western setting and dose–response meta-regression using actual carbohydrate intake at the follow-up. Results: Twenty-seven RCTs (n = 2,870; 7 Eastern, 20 Western) were included. Across analyzed time points, no arm sustained carbohydrate intake < 10 % of total energy; therefore, findings generalize to low-to-moderate carbohydrate rather than very-low-carbohydrate. LCDs improved glycemia short-term: HbA1c − 0.29 %, with the largest effect at 3 months. Fasting blood glucose decreased overall (−7.12 mg/dL). Weight loss was greatest at 3 months and attenuated thereafter. At 3 months, lower actual carbohydrate intake was related to larger HbA1c and weight reductions. Conclusions: LCDs offer modest, short-term metabolic benefits for type 2 diabetes management, but benefits diminish over time. Cultural context may shape responses, underscoring individualized, culturally tailored care.