Author, as appears in the article.: Chiavaroli, Laura; Lee, Danielle; Ahmed, Amna; Cheung, Annette; Khan, Tauseef A.; Mejia, Sonia Blanco; Mirrahimi, Arash; Jenkins, David J. A.; Livesey, Geoffrey; Wolever, Thomas M. S.; Rahelic, Dario; Kahleova, Hana; Salas-Salvado, Jordi; Kendall, Cyril W. C.; Sievenpiper, John L.;

Department: Bioquímica i Biotecnologia

URV's Author/s: Salas Salvadó, Jorge

Keywords: Waist circumference Type-2 Triacylglycerol blood level Triacylglycerol Treatment response Treatment outcome Systolic blood pressure Systematic review Risk algorithm Review Randomized controlled trial (topic) Publication bias Practice guideline Patient identification Outcome assessment Obesity Nutrition therapy Non insulin dependent diabetes mellitus Mexican-style diet Metabolic control Meta analysis Low density lipoprotein cholesterol level Low density lipoprotein cholesterol Lipid profile Insulin dependent diabetes mellitus Insulin Inflammation Improves dietary Impaired glucose-tolerance Humans Human High density lipoprotein cholesterol level High density lipoprotein cholesterol Hemoglobin a1c Grade approach Glycemic load Glycemic index Glycemic control Glucose blood level Glucose Fasting Dietary pattern Diet, diabetic Diet therapy Diastolic blood pressure Diabetic diet Diabetes mellitus, type 2 Diabetes mellitus, type 1 Diabetes mellitus Coronary-heart-disease Clinical practice Cardiovascular-disease Cardiometabolic risk factors Cardiometabolic risk factor C reactive protein Body weight Body mass Apolipoprotein b type-2 publication bias nutrition therapy mexican-style diet metabolic control lipid profile improves dietary impaired glucose-tolerance cardiovascular-disease

Abstract: OBJECTIVE To inform the update of the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy. DESIGN Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES Medline, Embase, and the Cochrane Library searched up to 13 May 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials of three or more weeks investigating the effect of diets with low glycaemic index (GI)/glycaemic load (GL) in diabetes. OUTCOME AND MEASURES The primary outcome was glycated haemoglobin (HbA1c). Secondary outcomes included other markers of glycaemic control (fasting glucose, fasting insulin); blood lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apo B, triglycerides); adiposity (body weight, BMI, waist circumference), blood pressure (systolic blood pressure (SBP) and diastolic blood pressure (DBP)), and inflammation (C reactive protein (CRP)). DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed risk of bias. Data were pooled by random effects models. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess the certainty of evidence. RESULTS 29 trial comparisons were identified in 1617 participants with type 1 and 2 diabetes who were predominantly middle aged, overweight, or obese with moderately controlled type 2 diabetes treated by hyperglycaemia drugs or insulin. Low GI/GL dietary patterns reduced HbA1c in comparison with higher GI/GL control diets (mean difference & minus;0.31% (95% confidence interval & minus;0.42 to & minus;0.19%), P < 0.001; substantial heterogeneity, I2=75%, P < 0.001). Reductions occurred also in fasting glucose, LDL-C, non-HDL-C, apo B, triglycerides, body weight, BMI, and CRP (P < 0.05), but not blood insulin, HDL-C, waist circumference, or blood pressure. A positive dose response gradient was seen for the difference in GL and HbA1c and for absolute dietary GI and SBP (P < 0.05). The certainty of evidence was high for the reduction in HbA1cand moderate for most secondary outcomes, with downgrades due mainly to imprecision. CONCLUSIONS This synthesis suggests that low GI/GL dietary patterns result in small important improvements in established targets of glycaemic control, blood lipids, adiposity, and inflammation beyond concurrent treatment with hyperglycaemia drugs or insulin, predominantly in adults with moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population. STUDY REGISTRATION ClinicalTrials.gov NCT04045938.<comment>Superscript/Subscript Available</comment

Thematic Areas: Saúde coletiva Odontología Medicine, general & internal Medicina iii Medicina ii Medicina i Interdisciplinar Educação física Ciências biológicas i Biotecnología

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: jordi.salas@urv.cat

Author identifier: 0000-0003-2700-7459

Record's date: 2023-02-19

Journal volume: 374

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://www.bmj.com/content/374/bmj.n1651

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Bmj-British Medical Journal. 374

APA: Chiavaroli, Laura; Lee, Danielle; Ahmed, Amna; Cheung, Annette; Khan, Tauseef A.; Mejia, Sonia Blanco; Mirrahimi, Arash; Jenkins, David J. A.; Livesey (2021). Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: systematic review and meta-analysis of randomised controlled trials. Bmj-British Medical Journal, 374(), -. DOI: 10.1136/bmj.n1651

Article's DOI: 10.1136/bmj.n1651

Entity: Universitat Rovira i Virgili

Journal publication year: 2021

Publication Type: Journal Publications