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 (body mass index), 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 −0.31% (95% confidence interval −0.42 to −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, systolic blood pressure (dose-response), and CRP (P<0.05), but not blood insulin, HDL-C, waist circumference, or diastolic 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 HbA1c and 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, blood pressure, 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.

College of Pharmacy and Nutrition University of Saskatchewan SK Canada

Consorcio CIBER MP Fisiopatología de la Obesidad y Nutrición Instituto de Salud Carlos 3 Madrid Spain

Department of Medical Imaging Faculty of Medicine University of Toronto Toronto ON Canada

Department of Medicine Temerty Faculty of Medicine University of Toronto Toronto ON Canada

Department of Nutritional Sciences Temerty Faculty of Medicine University of Toronto Toronto ON Canada

Division of Endocrinology and Metabolism Department of Medicine St Michael's Hospital Toronto ON Canada

Independent Nutrition Logic Wymondham UK

INQUIS Clinical Research Toronto ON Canada

Institut d'Investigació Sanitària Pere Virgili Hospital Universitari San Joan de Reus Reus Spain

Institute for Clinical and Experimental Medicine Diabetes Centre Prague Czech Republic

Li Ka Shing Knowledge Institute St Michael's Hospital Toronto ON Canada

Physicians Committee for Responsible Medicine Washington DC USA

School of Medicine Josip Juraj Strossmayer University of Osijek Osijek Croatia

School of Medicine University of Zagreb Zagreb Croatia

Toronto 3D Knowledge Synthesis and Clinical Trials Unit Clinical Nutrition and Risk Factor Modification Centre St Michael's Hospital Toronto ON Canada

Universitat Rovira i Virgili Departament de Bioquímica i Biotecnologia Unitat de Nutrició Humana Reus Spain

Vuk Vrhovac University Clinic for Diabetes Endocrinology and Metabolic Diseases Merkur University Hospital Zagreb Croatia

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BMJ. 2021 Aug 26;374:n2114. doi: 10.1136/bmj.n2114. PubMed

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Diabetes Canada Clinical Practice Guidelines Expert C . Sievenpiper JL, Chan CB, Dworatzek PD, Freeze C, Williams SL. Nutrition Therapy. Can J Diabetes 2018;42(Suppl 1):S64-79. PubMed

Wolever TMS. The glycaemic index: A physiological classification of dietary carbohydrate. CABI, 2006: 1-22710.1079/9781845930516.0000. DOI

Anderson TJ, Grégoire J, Pearson GJ, et al. . 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult. Can J Cardiol 2016;32:1263-82. 10.1016/j.cjca.2016.07.510 PubMed DOI

Lichtenstein AH, Appel LJ, Brands M, et al. American Heart Association Nutrition Committee . Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 2006;114:82-96. 10.1161/CIRCULATIONAHA.106.176158 PubMed DOI

Evert AB, Boucher JL, Cypress M, et al. American Diabetes Association . Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2013;36:3821-42. 10.2337/dc13-2042 PubMed DOI PMC

Evert AB, Dennison M, Gardner CD, et al. . Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care 2019;42:731-54. 10.2337/dci19-0014 PubMed DOI PMC

Thomas DE, Elliott EJ. The use of low-glycaemic index diets in diabetes control. Br J Nutr 2010;104:797-802. 10.1017/S0007114510001534 PubMed DOI

Thomas D, Elliott EJ. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus. Cochrane Database Syst Rev 2009;(1):CD006296. 10.1002/14651858.CD006296.pub2 PubMed DOI PMC

Ojo O, Ojo OO, Adebowale F, Wang XH. The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2018;10:E373. 10.3390/nu10030373 PubMed DOI PMC

Wang Q, Xia W, Zhao Z, Zhang H. Effects comparison between low glycemic index diets and high glycemic index diets on HbA1c and fructosamine for patients with diabetes: A systematic review and meta-analysis. Prim Care Diabetes 2015;9:362-9. 10.1016/j.pcd.2014.10.008 PubMed DOI

Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr 2013;97:505-16. 10.3945/ajcn.112.042457 PubMed DOI

Viguiliouk E, Nishi SK. TMS W, Sievenpiper J. Point: glycemic index an important but oft misunderstood marker of carbohydrate quality. Cereal Foods World 2018;63:158-64.

Livesey G, Taylor R, Livesey HF, et al. . Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Nutrients 2019;11:E1280. 10.3390/nu11061280 PubMed DOI PMC

Livesey G, Livesey H. Coronary Heart Disease and Dietary Carbohydrate, Glycemic Index, and Glycemic Load: Dose-Response Meta-analyses of Prospective Cohort Studies. Mayo Clin Proc Innov Qual Outcomes 2019;3:52-69. 10.1016/j.mayocpiqo.2018.12.007 PubMed DOI PMC

Mirrahimi A, de Souza RJ, Chiavaroli L, et al. . Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts. J Am Heart Assoc 2012;1:e000752. 10.1161/JAHA.112.000752 PubMed DOI PMC

Mirrahimi A, Chiavaroli L, Srichaikul K, et al. . The role of glycemic index and glycemic load in cardiovascular disease and its risk factors: a review of the recent literature. Curr Atheroscler Rep 2014;16:381. 10.1007/s11883-013-0381-1 PubMed DOI

Davies MJ, D’Alessio DA, Fradkin J, et al. . Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018;61:2461-98. 10.1007/s00125-018-4729-5 PubMed DOI

Mann JI, De Leeuw I, Hermansen K, et al. Diabetes and Nutrition Study Group (DNSG) of the European Association . Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus. Nutr Metab Cardiovasc Dis 2004;14:373-94. 10.1016/S0939-4753(04)80028-0 PubMed DOI

Diabetes UK Nutrition working group. Evidence-based nutrition guidelines for the prevention and management of diabetes. 2011. https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/evidence-based-nutrition-guidelines-for-the-prevention-and-management-of-diabetes. PubMed

Australia D. General practice management of type 2 diabetes – 2014-15. The Royal Australian College of General Practitioners and Diabetes Australia, 2014, https://www.diabetesaustralia.com.au/best-practice-guidelines.

Cai X, Wang L, Wang X, Liu S. Effect of high dietary fiber low glycemic index diet on intestinal flora, blood glucose and inflammatory response in T2DM patients. Biomed Res 2017;28:9371-5.

Elhayany A, Lustman A, Abel R, Attal-Singer J, Vinker S. A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: a 1-year prospective randomized intervention study. Diabetes Obes Metab 2010;12:204-9. 10.1111/j.1463-1326.2009.01151.x PubMed DOI

Fabricatore AN, Wadden TA, Ebbeling CB, et al. . Targeting dietary fat or glycemic load in the treatment of obesity and type 2 diabetes: a randomized controlled trial. Diabetes Res Clin Pract 2011;92:37-45. 10.1016/j.diabres.2010.12.016 PubMed DOI PMC

Gomes JMG, Fabrini SP, Alfenas RCG. Low glycemic index diet reduces body fat and attenuates inflammatory and metabolic responses in patients with type 2 diabetes. Arch Endocrinol Metab 2017;61:137-44. 10.1590/2359-3997000000206 PubMed DOI PMC

Gutschall MD, Miller CK, Mitchell DC, Lawrence FR. A randomized behavioural trial targeting glycaemic index improves dietary, weight and metabolic outcomes in patients with type 2 diabetes. Public Health Nutr 2009;12:1846-54. 10.1017/S1368980008004680 PubMed DOI

Jenkins DJ, Kendall CW, Vuksan V, et al. . Effect of lowering the glycemic load with canola oil on glycemic control and cardiovascular risk factors: a randomized controlled trial. Diabetes Care 2014;37:1806-14. 10.2337/dc13-2990 PubMed DOI

Jenkins DJ, Kendall CW, Augustin LS, et al. . Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial. Arch Intern Med 2012;172:1653-60. 10.1001/2013.jamainternmed.70 PubMed DOI

Ma Y, Olendzki BC, Merriam PA, et al. . A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes. Nutrition 2008;24:45-56. 10.1016/j.nut.2007.10.008 PubMed DOI PMC

Pavithran N, Kumar H, Menon AS, Pillai GK, Sundaram KR, Ojo O. The Effect of a Low GI Diet on Truncal Fat Mass and Glycated Hemoglobin in South Indians with Type 2 Diabetes-A Single Centre Randomized Prospective Study. Nutrients 2020;12:E179. 10.3390/nu12010179 PubMed DOI PMC

Visek J, Lacigova S, Cechurova D, Rusavy Z. Comparison of a low-glycemic index vs standard diabetic diet. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014;158:112-6. 10.5507/bp.2012.103 PubMed DOI

Yusof BN, Talib RA, Kamaruddin NA, Karim NA, Chinna K, Gilbertson H. A low-GI diet is associated with a short-term improvement of glycaemic control in Asian patients with type 2 diabetes. Diabetes Obes Metab 2009;11:387-96. 10.1111/j.1463-1326.2008.00984.x PubMed DOI

Higgins J, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions version 6.1, 2019 https://training.cochrane.org/handbook PubMed PMC

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. 10.1371/journal.pmed.1000097 PubMed DOI PMC

Wilczynski NL, Morgan D, Haynes RB, Hedges Team . An overview of the design and methods for retrieving high-quality studies for clinical care. BMC Med Inform Decis Mak 2005;5:20. 10.1186/1472-6947-5-20 PubMed DOI PMC

Bray GA, Popkin BM. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the sugar. Diabetes Care 2014;37:950-6. 10.2337/dc13-2085 PubMed DOI PMC

DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177-88. 10.1016/0197-2456(86)90046-2 PubMed DOI

Luo D, Wan X, Liu J, Tong T. Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res 2018;27:1785-805. 10.1177/0962280216669183 PubMed DOI

Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014;14:135. 10.1186/1471-2288-14-135 PubMed DOI PMC

Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol 2002;31:140-9. 10.1093/ije/31.1.140 PubMed DOI

Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 1992;45:769-73. 10.1016/0895-4356(92)90054-Q PubMed DOI

Balk EM, Earley A, Patel K, Trikalinos TA, Dahabreh IF. Empirical Assessment of Within-Arm Correlation Imputation in Trials of Continuous Outcomes. Agency for Healthcare Research and Quality, 2012. PubMed

Ku H. Notes on the Use of Propagation of Error Formulas, J Research of National Bureau of Standards-C. Engineering and Instrumentation 1966;70C:263-73.

Thompson SG, Higgins JP. How should meta-regression analyses be undertaken and interpreted? Stat Med 2002;21:1559-73. 10.1002/sim.1187 PubMed DOI

Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to metaanalysis. Wiley, 2008.

Fu R, Gartlehner G, Grant M, et al. . Conducting quantitative synthesis when comparing medical interventions: AHRQ and the Effective Health Care Program. J Clin Epidemiol 2011;64:1187-97. 10.1016/j.jclinepi.2010.08.010 PubMed DOI

Harrell FEJ. Regression Modeling Strategies-with Applications to Linear Models, Logistic Regression, and Survival Analysis: Springer Series in Statistics. Springer, 2001, 10.1007/978-1-4757-3462-1. DOI

Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol 2008;61:991-6. 10.1016/j.jclinepi.2007.11.010 PubMed DOI

Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-34. 10.1136/bmj.315.7109.629 PubMed DOI PMC

Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088-101. 10.2307/2533446 PubMed DOI

Duval S, Tweedie R. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000;56:455-63. 10.1111/j.0006-341X.2000.00455.x PubMed DOI

Guyatt G, Oxman AD, Akl EA, et al. . GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 2011;64:383-94. 10.1016/j.jclinepi.2010.04.026 PubMed DOI

Schünemann H, Brożek J, Guyatt G, Oxman A, eds. GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations. GRADE Working Group, 2013. https://gdt.gradepro.org/app/handbook/handbook.html.

Santesso N, Glenton C, Dahm P, et al. GRADE Working Group . GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions. J Clin Epidemiol 2020;119:126-35. 10.1016/j.jclinepi.2019.10.014 PubMed DOI

Brand JC, Colagiuri S, Crossman S, Allen A, Roberts DC, Truswell AS. Low-glycemic index foods improve long-term glycemic control in NIDDM. Diabetes Care 1991;14:95-101. 10.2337/diacare.14.2.95 PubMed DOI

Collier GR, Giudici S, Kalmusky J, et al. . Low glycaemic index starchy foods improve glucose control and lower serum cholesterol in diabetic children. Diabetes Nutr Metab 1988;1:11-9.

Fontvieille AM, Rizkalla SW, Penfornis A, Acosta M, Bornet FR, Slama G. The use of low glycaemic index foods improves metabolic control of diabetic patients over five weeks. Diabet Med 1992;9:444-50. 10.1111/j.1464-5491.1992.tb01815.x PubMed DOI

Fontvieille AM, Acosta M, Rizkalla SW, et al. . A moderate switch from high to low glycaemic-index foods for 3 weeks improves the metabolic control of Type 1 (IDDM) diabetic subjects. Diabetes Nutr Metab 1988;1:139-43.

Frost G, Wilding J, Beecham J. Dietary advice based on the glycaemic index improves dietary profile and metabolic control in type 2 diabetic patients. Diabet Med 1994;11:397-401. 10.1111/j.1464-5491.1994.tb00292.x PubMed DOI

Giacco R, Parillo M, Rivellese AA, et al. . Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes Care 2000;23:1461-6. 10.2337/diacare.23.10.1461 PubMed DOI

Gilbertson HR, Brand-Miller JC, Thorburn AW, Evans S, Chondros P, Werther GA. The effect of flexible low glycemic index dietary advice versus measured carbohydrate exchange diets on glycemic control in children with type 1 diabetes. Diabetes Care 2001;24:1137-43. 10.2337/diacare.24.7.1137 PubMed DOI

Heilbronn LK, Noakes M, Clifton PM. The effect of high- and low-glycemic index energy restricted diets on plasma lipid and glucose profiles in type 2 diabetic subjects with varying glycemic control. J Am Coll Nutr 2002;21:120-7. 10.1080/07315724.2002.10719204 PubMed DOI

Järvi AE, Karlström BE, Granfeldt YE, Björck IE, Asp NG, Vessby BO. Improved glycemic control and lipid profile and normalized fibrinolytic activity on a low-glycemic index diet in type 2 diabetic patients. Diabetes Care 1999;22:10-8. 10.2337/diacare.22.1.10 PubMed DOI

Jenkins DJ, Kendall CW, McKeown-Eyssen G, et al. . Effect of a low-glycemic index or a high-cereal fiber diet on type 2 diabetes: a randomized trial. JAMA 2008;300:2742-53. 10.1001/jama.2008.808 PubMed DOI

Jimenez-Cruz A, Bacardi-Gascon M, Turnbull WH, Rosales-Garay P, Severino-Lugo I. A flexible, low-glycemic index mexican-style diet in overweight and obese subjects with type 2 diabetes improves metabolic parameters during a 6-week treatment period. Diabetes Care 2003;26:1967-70. 10.2337/diacare.26.7.1967 PubMed DOI

Jimenez-Cruz A, Turnbull WH, Bacardi-Gascon M, Rosales-Garay P. A high-fiber, moderate-glycemic-index, Mexican style diet improves dyslipidemia in individuals with type 2 diabetes. Nutr Res 2004;24:19-2710.1016/j.nutres.2003.09.005. DOI

Komindr S, Ingsriswang S, Lerdvuthisopon N, Boontawee A. Effect of long-term intake of Asian food with different glycemic indices on diabetic control and protein conservation in type 2 diabetic patients. J Med Assoc Thai 2001;84:85-97. PubMed

Luscombe ND, Noakes M, Clifton PM. Diets high and low in glycemic index versus high monounsaturated fat diets: effects on glucose and lipid metabolism in NIDDM. Eur J Clin Nutr 1999;53:473-8. 10.1038/sj.ejcn.1600779 PubMed DOI

Rizkalla SW, Taghrid L, Laromiguiere M, et al. . Improved plasma glucose control, whole-body glucose utilization, and lipid profile on a low-glycemic index diet in type 2 diabetic men: a randomized controlled trial. Diabetes Care 2004;27:1866-72. 10.2337/diacare.27.8.1866 PubMed DOI

Wolever TM, Gibbs AL, Mehling C, et al. . The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr 2008;87:114-25. 10.1093/ajcn/87.1.114 PubMed DOI

Wolever TM, Jenkins DJ, Vuksan V, Jenkins AL, Wong GS, Josse RG. Beneficial effect of low-glycemic index diet in overweight NIDDM subjects. Diabetes Care 1992;15:562-4. 10.2337/diacare.15.4.562 PubMed DOI

Pavithran N, Kumar H, Menon AS, Pillai GK, Sundaram KR, Ojo O. South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes. Int J Environ Res Public Health 2020;17:E6232. 10.3390/ijerph17176232 PubMed DOI PMC

Goff LM, Cowland DE, Hooper L, Frost GS. Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials. Nutr Metab Cardiovasc Dis 2013;23:1-10. 10.1016/j.numecd.2012.06.002 PubMed DOI

Zafar MI, Mills KE, Zheng J, et al. . Low-glycemic index diets as an intervention for diabetes: a systematic review and meta-analysis. Am J Clin Nutr 2019;110:891-902. 10.1093/ajcn/nqz149 PubMed DOI

Schwingshackl L, Hoffmann G. Long-term effects of low glycemic index/load vs. high glycemic index/load diets on parameters of obesity and obesity-associated risks: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2013;23:699-706. 10.1016/j.numecd.2013.04.008 PubMed DOI

Milajerdi A, Saneei P, Larijani B, Esmaillzadeh A. The effect of dietary glycemic index and glycemic load on inflammatory biomarkers: a systematic review and meta-analysis of randomized clinical trials. Am J Clin Nutr 2018;107:593-606. 10.1093/ajcn/nqx042 PubMed DOI

Evans CE, Greenwood DC, Threapleton DE, Gale CP, Cleghorn CL, Burley VJ. Glycemic index, glycemic load, and blood pressure: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2017;105:1176-90. 10.3945/ajcn.116.143685 PubMed DOI

Jenkins DJA, Dehghan M, Mente A, et al. PURE Study Investigators . Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality. N Engl J Med 2021;384:1312-22. 10.1056/NEJMoa2007123 PubMed DOI

Korsmo-Haugen HK, Brurberg KG, Mann J, Aas AM. Carbohydrate quantity in the dietary management of type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab 2019;21:15-27. 10.1111/dom.13499 PubMed DOI

Scientific Advisory Committee on Nutrition. Lower carbohydrate diets for adults with type 2 diabetes. 2021. https://www.gov.uk/government/publications/sacn-report-lower-carbohydrate-diets-for-type-2-diabetes.

Goldenberg JZ, Day A, Brinkworth GD, et al. . Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. BMJ 2021;372:m4743. PubMed PMC

Hill AB. The environment and disease: Association or causation? Proc R Soc Med 1965;58:295-300. 10.1177/003591576505800503 PubMed DOI PMC

Augustin LS, Kendall CW, Jenkins DJ, et al. . Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis 2015;25:795-815. 10.1016/j.numecd.2015.05.005 PubMed DOI

Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M, STOP-NIDDM Trail Research Group . Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002;359:2072-7. 10.1016/S0140-6736(02)08905-5 PubMed DOI

Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M, STOP-NIDDM Trial Research Group . Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA 2003;290:486-94. 10.1001/jama.290.4.486 PubMed DOI

Holman RR, Coleman RL, Chan JCN, et al. ACE Study Group . Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol 2017;5:877-86. 10.1016/S2213-8587(17)30309-1 PubMed DOI

Hanefeld M, Cagatay M, Petrowitsch T, Neuser D, Petzinna D, Rupp M. Acarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies. Eur Heart J 2004;25:10-6. 10.1016/S0195-668X(03)00468-8 PubMed DOI

van de Laar FA, Lucassen PL, Akkermans RP, van de Lisdonk EH, Rutten GE, van Weel C. Alpha-glucosidase inhibitors for patients with type 2 diabetes: results from a Cochrane systematic review and meta-analysis. Diabetes Care 2005;28:154-63. 10.2337/diacare.28.1.154 PubMed DOI

Pellegrini N, Serafini M, Salvatore S, Del Rio D, Bianchi M, Brighenti F. Total antioxidant capacity of spices, dried fruits, nuts, pulses, cereals and sweets consumed in Italy assessed by three different in vitro assays. Mol Nutr Food Res 2006;50:1030-8. 10.1002/mnfr.200600067 PubMed DOI

Zaupa M, Scazzina F, Dall’Asta M, et al. . In vitro bioaccessibility of phenolics and vitamins from durum wheat aleurone fractions. J Agric Food Chem 2014;62:1543-9. 10.1021/jf404522a PubMed DOI

Lillioja S, Neal AL, Tapsell L, Jacobs DR, Jr. Whole grains, type 2 diabetes, coronary heart disease, and hypertension: links to the aleurone preferred over indigestible fiber. Biofactors 2013;39:242-58. 10.1002/biof.1077 PubMed DOI PMC

Fardet A. New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre? Nutr Res Rev 2010;23:65-134. 10.1017/S0954422410000041 PubMed DOI

Porta N, Bonet C, Cobo E. Discordance between reported intention-to-treat and per protocol analyses. J Clin Epidemiol 2007;60:663-9. 10.1016/j.jclinepi.2006.09.013 PubMed DOI

Committee for Medicinal Products for Human Use. Guideline on clinical investigation of medicinal products in the treatment or prevention of diabetes mellitus (Draft Guidance). CPMP/EWP/1080/00 Rev 2. European Medicines Agency, 2018.

Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229-34. 10.1056/NEJM199807233390404 PubMed DOI

Ray KK, Seshasai SR, Wijesuriya S, et al. . Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet 2009;373:1765-72. 10.1016/S0140-6736(09)60697-8 PubMed DOI

Mannucci E, Monami M, Lamanna C, Gori F, Marchionni N. Prevention of cardiovascular disease through glycemic control in type 2 diabetes: a meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 2009;19:604-12. 10.1016/j.numecd.2009.03.021 PubMed DOI

Turnbull FM, Abraira C, Anderson RJ, et al. Control Group . Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia 2009;52:2288-98. 10.1007/s00125-009-1470-0 PubMed DOI

Robinson JG, Smith B, Maheshwari N, Schrott H. Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta-regression analysis. J Am Coll Cardiol 2005;46:1855-62. 10.1016/j.jacc.2005.05.085 PubMed DOI

Manson JE, Tosteson H, Ridker PM, et al. . The primary prevention of myocardial infarction. N Engl J Med 1992;326:1406-16. 10.1056/NEJM199205213262107 PubMed DOI

Chiavaroli L, Mirrahimi A, Ireland C, et al. . Low-glycaemic index diet to improve glycaemic control and cardiovascular disease in type 2 diabetes: design and methods for a randomised, controlled, clinical trial. BMJ Open 2016;6:e012220. 10.1136/bmjopen-2016-012220 PubMed DOI PMC

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