Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In this randomized controlled trial, HbA1c was significantly reduced in type 2 diabetes (T2D) patients that ate a low-carbohydrate (LC) breakfast at the end of the study, compared to the start.

2. Furthermore, T2D patients who ate the LC breakfast exhibited improvements in mean and maximum glucose, glycemic variability, and time above range compared to the control group.

Evidence Rating Level: 1 (Excellent)

It is well known that hyperglycemic episodes are a predictor of complications in patients with type 2 diabetes (T2D). Consumption of carbohydrates can result in a spike in blood glucose for patients with T2D, particularly in the morning when glucose intolerance is the greatest. As a result, a high-carbohydrate breakfast can have a significant impact on hyperglycemia. Therefore, the purpose of this study was to determine if consumption of a low-carbohydrate (LC) breakfast could lead to better glycemic control in patients with T2D.

The study included 127 participants from Canada and Australia who responded to online advertisements between October 2020 and March 2022. Participants aged 20-79 years old were included if they had physician-diagnosed T2D for ≥1 year, a current HbA1C <8.5%, body mass index (BMI) >25 kg/m2, and blood pressure < 160/99 mmHg. Participants who were smokers, undergoing medical treatment for various diseases, had allergies or dietary restrictions that prevented adherence to the study intervention, or were using exogenous insulin, >3 glucose-lowering medications, HRT, corticosteroids, or anti-inflammatory medications were excluded from the study. Participants were randomized 1:1 to either the LC or low-fat control (CTL) breakfast group for the 12-week study period. Blood samples were taken at baseline and after the 12-week Food records and anthropomorphic measures were provided by self-reports. The primary outcome was the change in HbA1c.

The results demonstrated that HbA1c was significantly reduced in the LC breakfast group at the end of the 12-week study period compared to the start. Meanwhile, the difference in HbA1c between the intervention and control groups was not statistically significant. However, mean and maximum glucose, glycemic variability, and time above range were all lower in the LC group compared to the CTL group. Despite these findings, the study was limited by the self-reported nature of diet and anthropomorphic measures, which could have impacted the results. Nonetheless, the study demonstrated that consuming a LC breakfast could be a helpful lifestyle intervention for improving glucose control in patients with T2D.

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