Analysis of the efficacy of low carbohydrate and ketogenic diets in the decrease of the type 2 diabetes mellitus markers: a systematic review
DOI:
https://doi.org/10.34019/1982-8047.2021.v47.32932Keywords:
Diabetes Mellitus, Type 2, Diet, Carbohydrates, Diet, Ketogenic, EfficacyAbstract
Introduction: In a scenario of inability of the current recommendations to epidemiologically control the progress of the disease, it remains uncertain which is the best nutritional strategy for individuals with type 2 diabetes mellitus. Objective: To analyze the effectiveness of low-carbohydrate diets in the metabolic markers and body weight in the treatment of type 2 diabetes mellitus. Material and Methods: The PRISMA methodology was applied to identify and analyze a sample of randomized clinical trials, on the comparison of the effects of low carbohydrate diets to moderate-high carbohydrate diets, from patients with type 2 diabetes mellitus, in studies with publication after January 1990. Results: 8 randomized clinical trials were selected. Both dietary strategies similarly reduced glycated hemoglobin values, with improvement tendency in low-carbohydrate diets. In most studies, weight loss, triglyceride values reduction, HDL-c values increase, a drop in fasting plasma glucose and assessments of continuous global glycemic action and the mean amplitude of excursions glycemic, was better in the low carbohydrate diet groups, demonstrating a maintenance of a more physiologically stable blood glucose profile. It is worth mentioning that the predominance of the hypoglycemic agents decrease in low carbohydrate diet groups is presented as an important advantage in the long term management of diabetes. Conclusion: Low-carbohydrate diets are safe, well-tolerated and can be accepted as a nutritional therapy option for individuals with type 2 diabetes mellitus.
Downloads
References
Zuuren EJV, Fedorowicz Z, Kuijpers T, Pijl H. Effects of low-carbohydrate- compared with low-fat-diet interventions on metabolic control in people with type 2 diabetes: a systematic review including GRADE assessments. The American Journal of Clinical Nutrition. 2018; 108(2):300-31. DOI: 10.1093/ajcn/nqy096
Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC et al. Corrigendum to “dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base”. Nutrition. 2019; 62:213. DOI: 10.1016/j.nut.2014.06.011.
Westman EC, Yancy WS, Humphreys M. Dietary treatment of diabetes mellitus in the pre-insulin era (1914-1922). Perspectives in Biology and Medicine. 2006; 49(1):77-83. DOI: 10.1353/pbm.2006.0017.
Skeaff CM, Miller J. Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomised controlled trials. Annals of Nutrition and Metabolism. 2009; 55(1-3):173-201. DOI: 10.1159/000229002.
Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, Macleod J et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. diabetes care. 2019; 42(5):731-54. DOI: 10.2337/dci19-0014
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Bmj. 2009; 339(jul21 1). DOI: 10.1136/bmj.b2700
Gumbiner B, Wendel JA, Mcdermott MP. Effects of diet composition and ketosis on glycemia during very-low-energy-diet therapy in obese patients with non-insulin-dependent diabetes mellitus. The American Journal of Clinical Nutrition. 1996; 63(1):110-5. DOI: 10.1093/ajcn/63.1.110.
Chang CR, Francois ME, Little JP. Restricting carbohydrates at breakfast is sufficient to reduce 24-hour exposure to postprandial hyperglycemia and improve glycemic variability. The American Journal of Clinical Nutrition. 2019; 109(5):1302-9. DOI: 10.1093/ajcn/nqy261
Myette-Côté É, Durrer C, Neudorf H, Bammert TD, Botezelli JD, Johnson JD et al. The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2018; 315(6). DOI: 10.1152/ajpregu.00240.2018.
Goday A, Bellido D, Sajoux I, Crujeiras AB, Burguera B, García-Luna PP et al. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutrition & Diabetes. 2016; 6(9). DOI: 10.1038/nutd.2016.36.
Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA et al. Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. The American Journal of Clinical Nutrition. 2015; 102(4):780-90. DOI: 10.3945/ajcn.115.112581
Saslow LR, Daubenmier JJ, Moskowitz JT, Kim S, Murphy EJ, Phinney SD et al. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutrition & Diabetes. 2017; 7(12). DOI:10.1038/s41387-017-0006-9
Saslow LR, Mason AE, Kim S, Goldman V, Ploutz-Snyder R, Bayandorian H et al. An online intervention comparing a very low-carbohydrate ketogenic diet and lifestyle recommendations versus a plate method diet in overweight individuals with type 2 diabetes: a randomized controlled trial. Journal of Medical Internet Research. 2017; 19(2). DOI: 10.2196/jmir.5806
Westman EC, Yancy WS, Mavropoulos JC, Marquart M, Mcduffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism. 2008; 5(1). DOI: 10.2196/jmir.5806
João Gustavo Rocha Peixoto Dos Santos, Barbosa FT, Fraga TS. A qualidade dos ensaios clínicos randomizados publicados no Jornal Vascular Brasileiro. Jornal Vascular Brasileiro. 2011; 10(1):9-16. DOI: 10.1590/S1677-54492011000100003
Souza RF. O que é um estudo clínico randomizado? Medicina. 2009; 42(1):3. DOI: 10.11606/issn.2176-7262.v42i1p3-8
Oliveira MAP, Velarde LGC, Sá RAM. Ensaios clínicos randomizados: série entendendo a pesquisa clínica 2. Femina. 2015; 43(1):8-11.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Gian Pietro Granja Filippo, Sophia Guaranys de Souza Leão Mateik, Anderson Franzen
This work is licensed under a Creative Commons Attribution 4.0 International License.
Cessão de Primeira Publicação à HU Revista
Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.
