Evidence map›Paper›PMID 41470896›Full record

Observational studyNutrients2025

Carbohydrate Reduction and a Holistic Model of Care in Diabetes Management: Insights from a Retrospective Multi-Year Audit in New Zealand.

Caryn Zinn, Jessica L Campbell, Lily Fraser, Glen Davies, Marcus Hawkins, Olivia Currie, Jared Cannons, David Unwin, Catherine Crofts, Tom Stewart and 1 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

11 authors.

Caryn ZinnHuman Potential Centre, School of Sport, Exercise & Health, Auckland University of Technology, Auckland 1142, New Zealand.ORCID 0000-0001-6185-7663
Jessica L CampbellHuman Potential Centre, School of Sport, Exercise & Health, Auckland University of Technology, Auckland 1142, New Zealand.ORCID 0000-0003-0119-2596
Lily FraserTuruki Healthcare-Mangere, Auckland 2022, New Zealand.
Glen DaviesReversal NZ, Taupo 3330, New Zealand.
Marcus HawkinsHighbrook Medical Centre, Auckland 2013, New Zealand.ORCID 0000-0002-5662-1944
Olivia CurrieReal Healthy Me, Christchurch 8011, New Zealand.
Jared CannonsTuruki Healthcare-Mangere, Auckland 2022, New Zealand.ORCID 0009-0000-8818-4278
David UnwinNorwood Surgery, Southport PR9 7EG, UK.ORCID 0000-0002-9950-254X
Catherine CroftsHuman Potential Centre, School of Sport, Exercise & Health, Auckland University of Technology, Auckland 1142, New Zealand.ORCID 0000-0001-6109-8513
Tom StewartHuman Potential Centre, School of Sport, Exercise & Health, Auckland University of Technology, Auckland 1142, New Zealand.ORCID 0000-0001-5915-3843
Grant SchofieldHuman Potential Centre, School of Sport, Exercise & Health, Auckland University of Technology, Auckland 1142, New Zealand.

Funding

Health Research Council of New Zealand 21/874
6 · The paper itself

Abstract

BACKGROUND/

objectivesThe global epidemic of type 2 diabetes (T2D) is a critical public health issue, particularly in New Zealand, where prevalence rates are high, especially among Māori and Pacific people. Recent research indicates that dietary interventions, particularly carbohydrate reduction, can lead to the remission or reversal of T2D. However, little is known about how such approaches perform when implemented in routine New Zealand primary care, particularly within high-risk and underserved populations. This study aimed to evaluate changes in HbA1c, diabetes status, and cardiometabolic outcomes among adults with prediabetes and T2D engaged in such a model of care.

methodsThis study reports findings from a retrospective, observational, real-world, multi-site clinical audit (service evaluation) of a holistic model of care implemented in three primary care practices in New Zealand. The model of care is characterised by a three-pronged approach: whole food, carbohydrate reduction; a health-coach, behaviour-change-based delivery approach; and community- or peer-based initiatives. Audit data from 106 patients with prediabetes (PD) and T2D were analysed (median follow-up 19 months; IQR 6-32) to assess changes in glycosylated haemoglobin (HbA1c) levels, diabetes status, and cardiometabolic outcomes.

resultsWe observed an overall reduction in HbA1c (median change -3 mmol/mol (IQR: -7 to 3),

conclusionsGiven the retrospective and uncontrolled audit design, findings should be interpreted with appropriate caution. However, the consistent improvements observed across multiple practices suggest that carbohydrate-reduction strategies within holistic models of care can meaningfully improve diabetes outcomes in real-world primary care settings. Future research should evaluate longer-term sustainability, implementation fidelity, and the applicability of this model at scale, particularly for Māori and Pacific communities.

Indexed as

Diabetes Mellitus, Type 2Dietary CarbohydratesDiet, Carbohydrate-RestrictedPrediabetic StateAdultAgedBlood GlucoseFemaleGlycated HemoglobinHumansMaleMiddle AgedNew ZealandPrimary Health CareRetrospective StudiesBlood GlucoseDietary CarbohydratesGlycated Hemoglobinhemoglobin A1c protein, humancarbohydrate reductionhealth-coachingholisticprediabetesremission

Identifiers

PMID41470896
PMCPMC12735679

What Socratic holds

Textmetadata
LicenceCC BY
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.