D. Anyang Kaakyire, OO. Abdelfattah, A. Kumar and S. Qadeer (2025). Efficacy of Low-Carbohydrate Diets Versus Low-Fat Diets in Glycemic Control Among Patients With Type 2 Diabetes: A Systematic Review. Cureus, 17(1), e77004. https://doi.org/10.7759/cureus.77004

PubMed 39912024

[Abstract]
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.