Low-carbohydrate diet improves glycemic control in patients with type 1 diabetes: a systematic review

Juan Daniel Cruz Castillo; Isela Esther Juárez Rojop; Manasés González Cortazar; German Alberto Nolasco Rosales; Thelma Beatriz Gonzalez Castro; Alejandro Marín Medina

doi:10.19136/hs.a25n1.6031

Authors

Juan Daniel Cruz Castillo Universidad Juárez Autónoma de Tabasco
Isela Esther Juárez Rojop Universidad Juárez Autónoma de Tabasco
Manasés González Cortazar Mexican Social Security Institute
German Alberto Nolasco Rosales Universidad Juárez Autónoma de Tabasco
Thelma Beatriz González Castro Universidad Juárez Autónoma de Tabasco
Alejandro Marín Medina University of Guadalajara

DOI:

https://doi.org/10.19136/hs.a25n1.6031

Abstract

Objective: This systematic review and meta-analysis aimed to evaluate the effects of LCDs on glycemic control in adults with T1D.

Material and Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science up to September 2024. Eligible studies included randomised controlled trials, cohort studies, and non-randomised interventions in adults with type 1 diabetes following LCD. Two review authors independently completed study selection, data extraction, and risk of bias assessment. Ninety-three records were discovered, of which eight research studies met the inclusion criteria. The effect of LCD on glycemic control was assessed using the standardised mean difference and 95% confidence intervals (CIs), calculated from pre- and post-intervention values. Publication bias was assessed using funnel plots and the Egger test, and heterogeneity was assessed using Cochran's Q statistic and I² index.

Results: Our results revealed significant reductions in HbA1c (point estimate: 0.79 mmol/mol; 95% CI: 0.57 to 1.02; p < 0.001) and total daily insulin dose (point estimate: 0.96 U; 95% CI: 0,67 to 1.25; p < 0.001) in adults with T1D following LCD interventions. Nonetheless, we observed no significant changes in lipid profile, anthropometric parameters, and blood pressure.

Conclusions: DBCs may be effective in conjunction with drug therapy to maintain glycemic control in people with T1D. Evidence is limited by sample sizes, variability in diets, and risk of bias. Trials with appropriate methodological designs are required to validate these findings.

Keywords: Low-carbohydrate diet; Type 1 diabetes; Glycemic control; HbA1c; Carbohydrate-restricted diets.

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Author Biographies

Juan Daniel Cruz Castillo, Universidad Juárez Autónoma de Tabasco

Master in Biomedical Sciences. PhD student in Biomedical Sciences. Academic Division of Health Sciences. Universidad Juárez Autónoma de Tabasco. Villahermosa, Tabasco. Mexico.
Isela Esther Juárez Rojop, Universidad Juárez Autónoma de Tabasco

PhD in Research in Medicine. Research Professor. Academic Division of Health Sciences. Universidad Juárez Autónoma de Tabasco. Villahermosa, Tabasco. Mexico
Manasés González Cortazar, Mexican Social Security Institute

PhD in Chemical Sciences. Associate Researcher at the Southern Biomedical Research Center. Mexican Institute of Social Security. Xochitepec, Morelos, Mexico.
German Alberto Nolasco Rosales, Universidad Juárez Autónoma de Tabasco

PhD in Biomedical Sciences. Research Professor of the Academic Division of Health Sciences. Universidad Juárez Autónoma de Tabasco. Villahermosa, Tabasco. Mexico.
Thelma Beatriz González Castro, Universidad Juárez Autónoma de Tabasco

1. PhD in Biomedical Sciences. Research Professor of the Multidisciplinary Academic Division of Jalpa de Méndez. Universidad Juárez Autónoma de Tabasco. Jalpa de Méndez, Tabasco. Mexico.
Alejandro Marín Medina, University of Guadalajara

PhD in Human Genetics. Research Professor in the Department of Molecular Biology and Genomics. University Center for Health Sciences (CUCS). University of Guadalajara. Guadalajara, Jalisco. Mexico.