Evidence map›Paper›PMID 36064937›Full record

SynthesisDiabetes, obesity & metabolism2022

Very low carbohydrate (ketogenic) diets in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials.

Amber Parry-Strong, Morag Wright-McNaughton, Mark Weatherall, Rosemary M Hall, Kirsten J Coppell, Christine Barthow, Jeremy D Krebs

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.

  1. Pooled it
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  15. Low-carbohydrate diet for people with type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2024
    Article
  16. Review
  17. Metabolic Messengers: ketone bodies.Nature metabolism · 2023
    Review
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  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Amber Parry-StrongDepartment of Medicine, Division of Health Sciences, University of Otago Wellington, School of Medicine and Health Sciences Building, Wellington, New Zealand.ORCID 0000-0002-5427-9989
Morag Wright-McNaughtonDepartment of Medicine, Division of Health Sciences, University of Otago Wellington, School of Medicine and Health Sciences Building, Wellington, New Zealand.
Mark WeatherallDepartment of Medicine, Division of Health Sciences, University of Otago Wellington, School of Medicine and Health Sciences Building, Wellington, New Zealand.
Rosemary M HallDepartment of Medicine, Division of Health Sciences, University of Otago Wellington, School of Medicine and Health Sciences Building, Wellington, New Zealand.
Kirsten J CoppellDepartment of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Christine BarthowDepartment of Medicine, Division of Health Sciences, University of Otago Wellington, School of Medicine and Health Sciences Building, Wellington, New Zealand.
Jeremy D KrebsDepartment of Medicine, Division of Health Sciences, University of Otago Wellington, School of Medicine and Health Sciences Building, Wellington, New Zealand.ORCID 0000-0002-7850-3447
University of Otago · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimVery low carbohydrate/ketogenic diets (VLC/KDs) are popular but their role in managing pre-diabetes and type 2 diabetes (T2D) is uncertain. This study uses a systematic review and meta-analysis of randomized controlled trials to estimate the effect of these diets in this population. MATERIALS AND

methodsA systematic review identified randomized controlled trials of at least 6 months duration comparing efficacy and safety of VLC/KDs (≤50 g carbohydrate or ≤10% total energy from carbohydrate per day) with a control diet (carbohydrate above the VLC/KD threshold) in adults with pre-diabetes or T2D. The primary outcome variable was glycated haemoglobin (HbA1c) after 12 months. The meta-analysis method was inverse variance weighting of mean values for continuous variables.

resultsKey word searches identified 2290 studies; 2221 were not in scope. A full text review of 69 studies identified eight meeting inclusion criteria; in total, it involved 606 participants. Six studies reported HbA1c (%) at 12 months; four as change from baseline with a fixed effects estimate (95% confidence interval): VLC/KD minus control of 0.01% (-0.22 to 0.25), p = .91; and two as change from baseline: -0.65% (-0.99; -0.31) [-7.1 mmol/mol (-10.8; -3.4)], p < .001. Serum triglycerides were lower with VLC/KD versus control: -0.28 mmol/L (-0.44 to -0.11), p < .001. High-density lipoprotein was higher with an estimate of 0.04 mmol/L (0.01 to 0.08), p = .03, in the five studies reporting 12-month summary data.

conclusionsA VLC/KD may cause reductions in HbA1c and triglycerides in those with pre-diabetes or T2D but evidence of an advantage over other strategies is limited. More well-designed studies are required to provide certain evidence.

Indexed as

Diabetes Mellitus, Type 2Diet, KetogenicPrediabetic StateAdultDiet, Carbohydrate-RestrictedGlycated HemoglobinHumansRandomized Controlled Trials as TopicTriglyceridesGlycated HemoglobinTriglyceridesdietary interventioneffectivenessglycaemic controlmeta-analysissystematic reviewtype 2 diabetes

Identifiers

PMID36064937
PMCPMC9826205
OpenAlexW4291825645

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.