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Diet in the management of type 2 diabetes: umbrella review of systematic reviews with meta-analyses of randomised controlled trials
Umbrella review (88 publications; 312 meta-analyses) recalculating diet effects in type 2 diabetes: GRADE high-certainty benefits for liquid meal replacement on weight/BMI and for low-carbohydrate (<26% energy) patterns on HbA1c and triglycerides, amid mostly low-to-very-low review quality across the wider corpus.
Design
Umbrella review of SRs+MAs of ≥12-week RCTs in type 2 diabetes diets (PROSPERO CRD42021252309).
GRADE-high signals highlighted by authors
- Liquid meal replacement: mean weight difference −2.37 kg (95% CI −3.30 to −1.44; n = 9 RCTs in MA) and BMI −0.87 (−1.32 to −0.43; n = 8)
- Low carbohydrate (<26% of energy): HbA1c −0.47% (−0.60 to −0.34; n = 17) and fasting triglycerides −0.30 mmol/L (−0.43 to −0.17; n = 19)
Quality context
Only ~23% of included publications scored moderate-to-high on AMSTAR-2; 77% were low–very low—headline GRADE statements above are selective high-certainty islands in a heterogeneous sea.
Publication
Szczerba E, Barbaresko J, Schiemann T, et al. BMJ Med. 2023;2(1):e000664. PMID 38027413.
Outcomes
- HbA1c (Glycated Hemoglobin)-0.47% (Absolute Change)
- Liquid meal replacement: pooled weight MD −2.37 kg (95% CI −3.30 to −1.44; 9 RCTs) and BMI MD −0.87 (−1.32 to −0.43; 8 RCTs; GRADE high).
- Low-carbohydrate diets: pooled fasting triglycerides MD −0.30 mmol/L (95% CI −0.43 to −0.17; 19 RCTs; GRADE high).