Effects of Low-Carbohydrate Diets on Overweight and Obesity in Patients with Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes mellitus represents a major global health challenge, with over 90% of cases occurring in individuals who are overweight or obese. Lifestyle modification, particularly dietary intervention, is central to disease management. While several dietary patterns have demonstrated benefits, low-carbohydrate diets have drawn increasing attention due to their pronounced shortterm effects on glycemic control and weight reduction. Current evidence indicates that low-carbohydrate diets can significantly lower glycated hemoglobin, fasting plasma glucose, and triglycerides, while promoting diabetes remission in the initial months of intervention. These improvements are largely attributable to reduced glycemic load, enhanced insulin sensitivity, and reductions in visceral adiposity. However, findings on long-term efficacy and safety remain inconsistent. Adherence commonly declines over time, benefits often diminish after 12 months, and concerns have been raised regarding potential elevations in low-density lipoprotein cholesterol and increased mortality risk when carbohydrates are replaced with animal-derived fat and protein. Compared with Mediterranean diets, low-carbohydrate diets may achieve greater metabolic improvements in short term, but lack robust evidence of long-term cardiovascular protection. Overall, lowcarbohydrate diets can be considered an effective shortterm strategy, but future research should prioritize longterm randomized trials, standardized definitions, and personalized approaches to clarify their sustainable role in type 2 diabetes mellitus management.