Intervention Review

Dietary advice for treatment of type 2 diabetes mellitus in adults

  1. Lucie Nield1,*,
  2. Helen Moore1,
  3. Lee Hooper2,
  4. Kennedy Cruickshank3,
  5. Avni Vyas4,
  6. Vicki Whittaker5,
  7. Carolyn D Summerbell6

Editorial Group: Cochrane Metabolic and Endocrine Disorders Group

Published Online: 18 JUL 2007

Assessed as up-to-date: 30 OCT 2006

DOI: 10.1002/14651858.CD004097.pub4

How to Cite

Nield L, Moore H, Hooper L, Cruickshank K, Vyas A, Whittaker V, Summerbell CD. Dietary advice for treatment of type 2 diabetes mellitus in adults. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD004097. DOI: 10.1002/14651858.CD004097.pub4.

Author Information

  1. 1

    University of Teesside, School of Health and Social Care, Middlesbrough, Teesside, UK

  2. 2

    University of East Anglia, School of Medicine, Health Policy & Practice, Norwich, UK

  3. 3

    University of Manchester, Department of Public Health and Epidemiology, Manchester, UK

  4. 4

    University of Manchester, Division of Cardiovascular and Endocrine Sciences, Core Technology Facility (3rd Floor), Manchester, UK

  5. 5

    University of Teesside, Postgraduate Institute of Health, Middlesbrough, Teesside, UK

  6. 6

    Wolfson Research Institute, Durham University, School of Medicine and Health, Stockton-on-Tees, UK

*Lucie Nield, School of Health and Social Care, University of Teesside, Parkside West, Middlesbrough, Teesside, TS1 3BA, UK.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 JUL 2007




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak


While initial dietary management immediately after formal diagnosis is an 'accepted' cornerstone of treatment of type 2 diabetes mellitus, a formal and systematic overview of its efficacy and method of delivery is not currently available.


To assess the effects of type and frequency of different types of dietary advice for adults with type 2 diabetes.

Search methods

We carried out a comprehensive search of The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, bibliographies and contacted relevant experts.

Selection criteria

All randomised controlled trials, of six months or longer, in which dietary advice was the main intervention.

Data collection and analysis

The lead investigator performed all data extraction and quality scoring with duplication being carried out by one of the other six investigators independently with discrepancies resolved by discussion and consensus. Authors were contacted for missing data.

Main results

Thirty-six articles reporting a total of eighteen trials following 1467 participants were included. Dietary approaches assessed in this review were low-fat/high-carbohydrate diets, high-fat/low-carbohydrate diets, low-calorie (1000 kcal per day) and very-low-calorie (500 kcal per day) diets and modified fat diets. Two trials compared the American Diabetes Association exchange diet with a standard reduced fat diet and five studies assessed low-fat diets versus moderate fat or low-carbohydrate diets. Two studies assessed the effect of a very-low-calorie diet versus a low-calorie diet. Six studies compared dietary advice with dietary advice plus exercise and three other studies assessed dietary advice versus dietary advice plus behavioural approaches. The studies all measured weight and measures of glycaemic control although not all studies reported these in the articles published. Other outcomes which were measured in these studies included mortality, blood pressure, serum cholesterol (including LDL and HDL cholesterol), serum triglycerides, maximal exercise capacity and compliance. The results suggest that adoption of regular exercise is a good way to promote better glycaemic control in type 2 diabetic patients, however all of these studies were at high risk of bias.

Authors' conclusions

There are no high quality data on the efficacy of the dietary treatment of type 2 diabetes, however the data available indicate that the adoption of exercise appears to improve glycated haemoglobin at six and twelve months in people with type 2 diabetes. There is an urgent need for well-designed studies which examine a range of interventions, at various points during follow-up, although there is a promising study currently underway.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Dietary advice for treatment of type 2 diabetes mellitus in adults

No high quality data on the efficacy of diet alone exists for treatment of type 2 diabetes mellitus. This systematic review assesses the effects of studies that examined dietary advice with or without the addition of exercise or behavioural approaches. Eighteen studies were included. No data were found on micro- or macrovascular diabetic complications, mortality or quality of life. It is difficult to draw reliable conclusions from the limited data that are presented in this review, however, the addition of exercise to dietary advice showed improvement of metabolic control after six- and twelve-month follow-up.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak













参加者1467例を追跡した計18件の試験を報告した36件の論文を含めた。本レビューで評価を行った食事方法は、低脂肪/高炭水化物食、高脂肪/低炭水化物食、低カロリー食(1日1000kcal)および超低カロリー食(1日500kcal)ならびに加工油脂食であった。2件の試験ではAmerican Diabetes Association exchange dietと標準的な低脂肪食との比較、5件の研究では低脂肪食と中脂肪食または低炭水化物食との比較評価が行われていた。2件の研究では、超低カロリー食と低カロリー食の効果が比較評価されていた。6件の研究では食事指導と、食事指導と運動の併用が比較されており、他の3件の研究では食事指導と、食事指導と行動療法の併用が比較評価されていた。すべての研究で体重および血糖コントロールが測定されたが、すべての研究が発表論文の中でこれらを報告していたわけではなかった。これらの研究で測定されたその他のアウトカムには、死亡率、血圧、血清コレステロール(LDLおよびHDLコレステロールを含む)、血清トリグリセリド、最大運動能力ならびにコンプライアンスがあった。結果から、定期的な運動は2型糖尿病患者において良好な血糖コントロールを促進する良い方法であることが示唆されているが、これらの試験はすべてバイアスのリスクが高かった。




監  訳: 相原 守夫,2007.10.5

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak







我們針對The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED,文獻進行一次全面性的檢索,並且和有關專家聯繫。






共有36篇文章報導18個試驗,包括有1467位參加者。本評論文章所評估的飲食有低脂高碳水化合物飲食、高脂低碳水化合物飲食、低熱量(每天1000大卡)和極低熱量(每天500千卡)飲食和改良型脂肪飲食。兩個試驗比較美國糖尿病協會代換飲食與標準減少脂肪飲食和,5個研究評估低脂肪飲食與中度脂肪或低碳水化合物飲食。2個研究評估極低熱量飲食與低熱量飲食。6個研究比較飲食諮詢與飲食諮詢合併運動,其他3個研究評估飲食諮詢與飲食諮詢加上行為介入方法。所有的研究都測量體重與血糖控制,雖然並非所有發表的文章都有將其列入報告。這些研究測量的結果還包括死亡率、血壓、血清膽固醇(包括低密度脂蛋白和高密度脂蛋白膽固醇) 、血清三酸甘油酯、最大運動能力和遵囑性。結果顯示,第二型糖尿病患採用規律運動是一個控制血糖的好方法,但是所有這些研究有偏差的風險都很高。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。




Laički sažetak

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laički sažetak

Prehrambeni savjeti za liječenje dijabetesa tipa 2 u odraslih

Ne postoje visoko-kvalitetni podaci o učinkovitosti isključivo prehrane za liječenje dijabetesa tipa 2. Ovaj sustavni pregled ocjenjuje učinke studija koje su ispitivale prehrambene savjete sa ili bez dodatka vježbe ili bihevioralnih pristupa. Bilo je uključeno osamnaest studija. Nisu pronađeni podaci o mikro-ili makrovaskularnim dijabetičkim komplikacijama, smrtnosti ili kvaliteti života. Teško je izvući pouzdane zaključke iz ograničenih podataka koji su predstavljeni u ovom pregledu, no, dodavanje vježbe prehrambenim savjetima je pokazalo poboljšanje metaboličke kontrole nakon šest i dvanaest mjeseci praćenja.

Bilješke prijevoda

Prevoditelj:: Croatian Branch of the Italian Cochrane Centre
Prijevod financira:: Ministry of Education, Science and Sports