RESUMEN
Many current popular weight-loss diets advocate restricting carbohydrates, but risks and benefits of these diets for patients with diabetes is unclear. We searched for articles published in English between 1980 and April 2006 regarding carbohydrate-restricted diets that included and reported separate results for adult, nonpregnant patients with type 2 diabetes. Articles were limited to studies completed in the United States and Canada. Available data on study design; carbohydrate composition of diet; duration of diet; and the outcomes of weight, lipid levels (total, low-density lipoprotein and high-density lipoprotein cholesterol, and triglycerides), hemoglobin A1c percent and/or fasting glucose were extracted. A total of 56 studies or reviews were evaluated. Thirteen studies met our inclusion criteria. Meta-regression analyses show that hemoglobin A1c, fasting glucose, and some lipid fractions (triglycerides) improved with lower carbohydrate-content diets. Overall effect on weight was equivocal among the studies evaluated in this meta-analysis. Randomized, controlled studies of restricted-carbohydrate diets in patients with diabetes need to be conducted in order to evaluate the overall sustainability of outcomes and long-term safety.
Asunto(s)
Diabetes Mellitus Tipo 2/dietoterapia , Dieta Baja en Carbohidratos , Carbohidratos de la Dieta/administración & dosificación , Carbohidratos de la Dieta/metabolismo , Hemoglobina Glucada/metabolismo , Diabetes Mellitus Tipo 2/sangre , Femenino , Humanos , Metabolismo de los Lípidos/efectos de los fármacos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Resultado del TratamientoRESUMEN
OBJECTIVE: To review existing data to determine whether racial/ethnic disparities exist for self-monitoring of blood glucose (SMBG) among adults in the United States. STUDY DESIGN: A literature search of diabetes-related studies published from 1970 through June 2005 was conducted. Our search strategy included SMBG in minority populations with diabetes. METHODS: Studies were selected for review if they reported SMBG rates from a specific racial/ethnic minority group or if there were comparisons of SMBG rates across racial/ethnic groups. RESULTS: Twenty-two studies were reviewed that met the search criteria. Twelve studies included data from a single racial/ethnic minority group, and 10 studies included comparisons between non-Hispanic Whites and at least one racial/ethnic minority group. Data represented studies conducted in a variety of settings, such as healthcare facilities in a state or region of the United States and nationally representative surveys. Most of the data indicate that SMBG rates are generally low, regardless of the population. In comparative studies, some racial/ethnic differences overall were found in SMBG rates among all racial/ethnic minority groups when compared to non-Hispanic Whites. Across studies, patients taking insulin performed SMBG more frequently than did those not taking insulin. CONCLUSIONS: Despite widespread recommendations for self-monitoring of blood glucose, compliance is reported to be low in all groups in the United States, especially among racial/ ethnic minorities.