A major new study by the German Diabetes Center (DDZ) has evaluated the effect of diet on the management of type 2 diabetes and the prevention of complications. The review shows the positive effects of different diets (plant-based, Mediterranean, low-carbohydrate, high-protein) on cardiometabolic health in individuals with type 2 diabetes.

Led by DDZ researchers Edyta Szczerba and Dr. Sabrina Schlesinger from the Institute for Biometrics and Epidemiology of the German Diabetes Center, the team conducted the first comprehensive umbrella review, systematically analyzing 312 meta-analyses of randomized controlled trials (RCTs) to investigate the effect of different diets and dietary factors on the management of type 2 diabetes and the prevention of complications.

Lead author Szczerba emphasizes that diet plays a multifaceted role in the management of type 2 diabetes. “It is not only a matter of energy restriction; rather, various dietary approaches such as plant-based, Mediterranean, high-protein and low-carbohydrate diets have positive effects on cardiometabolic health in individuals with type 2 diabetes,” she concludes.

Main Findings of the Study
Diverse dietary approaches: The study identifies that various dietary approaches go beyond mere energy restriction and can offer targeted benefits for people with type 2 diabetes.

Positive effects: Besides blood sugar management, different diets are also beneficial for cardiometabolic health, including the risk of cardiovascular diseases and further diabetes-related complications.

Holistic approach: The study underscores the importance of a holistic approach to nutritional advice for people with type 2 diabetes that not only focuses on weight management but also promotes a healthy lifestyle in the long term.

“Robust evidence of reductions in body weight was found for both energy restriction, such as through liquid meal replacement products, and for plant-based and low-carbohydrate diets. A low-carbohydrate diet also had a positive effect on levels of hemoglobin A1c and triglycerides,” highlights Dr. Sabrina Schlesinger. Positive effects on numerous cardiovascular risk markers could also be demonstrated for plant-based, Mediterranean, low-carbohydrate and high-protein dietary approaches as well as a higher intake of omega-3 fatty acids. Other dietary regimens, such as a ketogenic diet or intermittent fasting, also reduced body weight, though there was less confidence in these results.

Significance for Practice
“With this comprehensive review of over 300 meta-analyses, we were able to obtain systematic findings on the effect of diet in individuals with type 2 diabetes for the first time,” says the expert. These findings also have impacts on clinical practice. “These analyses show that a wide range of diets can be successful in diabetes management. Future studies are now required to determine who benefits most from which diet in the long term in order to provide targeted recommendations tailored to the respective needs and preferences of the individuals concerned,” also underlines Prof. Michael Roden, director of the Department of Endocrinology and Diabetology at the University Clinics Düsseldorf and director of the DDZ, in conclusion.
 

Original publication:
Szczerba E, Barbaresko J, Schiemann T et al. Diet in the management of type 2 diabetes: umbrella review of systematic reviews with meta-analyses of randomised controlled trials. BMJ Medicine 2023;2:e000664.
doi: 10.1136/bmjmed-2023-000664
 

Press contact: 
Isabelle Keller 
Press officer DDZ
isabelle.keller(at)ddz.de  
+49 (0)211 3382-450 

The German Diabetes Center (DDZ) serves as the German reference center for diabetes. Its objective is to contribute to the improvement of prevention, early detection, diagnosis and treatment of diabetes mellitus. At the same time, the research center aims at improving the epidemiological data situation in Germany. The DDZ coordinates the multicenter German Diabetes Study and is a point of contact for all players in the health sector. In addition, it prepares scientific information on diabetes mellitus and makes it available to the public. The DDZ is part of the Leibniz Association (Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz, WGL) and is a partner of the German Center for Diabetes Research (DZD e.V.). www.ddz.de/en 

The German Center for Diabetes Research (DZD) is a national association that brings together experts in the field of diabetes research and combines basic research, translational research, epidemiology and clinical applications. The aim is to develop novel strategies for personalized prevention and treatment of diabetes. Members are Helmholtz Munich – German Research Center for Environmental Health, the German Diabetes Center in Düsseldorf, the German Institute of Human Nutrition in Potsdam-Rehbrücke, the Paul Langerhans Institute Dresden of Helmholtz Munich at the University Medical Center Carl Gustav Carus of the TU Dresden and the Institute for Diabetes Research and Metabolic Diseases of Helmholtz Munich at the Eberhard-Karls-University of Tuebingen together with associated partners at the Universities in Heidelberg, Cologne, Leipzig, Lübeck and Munich. www.dzd-ev.de/en