Effects of a Low‐Carbohydrate Diet Combined With Exercise on HbA1c in Adults With Type 2 Diabetes: A Bayesian Multilevel Network and Dose–Response Meta‐Analysis
Pooled result · HbA1cResult — go to the resultPosterior median mean difference −0.53 percentage points 95% CrI −0.76 to −0.28Authors' conclusion
Limitations of the arm-level model, sparse evidence and very low confidence in the assessed auxiliary-network comparisons leave comparative benefits uncertain.
Study context
- Population
- Adults with T2D; English-language randomized controlled trials (RCTs)
- Participants
- 2,038 adults24 RCTs
- Comparison
- Carbohydrate-restricted diets combined with exercise vs pooled active/passive controls
- Outcome
- Change in HbA1c
Methodological detailsBayesian multilevel model, arm-level synthesis, auxiliary frequentist network meta-analysis, Confidence in Network Meta-Analysis (CINeMA), exploratory dose–response and moderator analyses, Risk of bias assessed with revised Cochrane tool
- Bayesian multilevel model
- Arm-level synthesis
- Auxiliary frequentist network meta-analysis
- CINeMA
- Exploratory dose–response and moderator analyses
- Risk of bias assessed with revised Cochrane tool
Pooled result
HbA1c
Posterior median mean difference
−0.53 percentage points
95% CrI −0.76 to −0.28
Aerobic training + moderately low-carbohydrate dietvs Pooled active/passive controls
posterior median mean difference −0.53 percentage points (95% CrI −0.76 to −0.28)
As reported in the abstract
Further pooled results
Model without treatment-specific effects
- Bayes factor favoured the model without treatment-specific effects
- BF10 = 0.034
Exercise dose–response
- Higher prescribed exercise doses associated with larger reductions vs pooled controls; incremental benefit over exercise or CRD alone not established
- Exploratory
Carbohydrate dose
- Matched carbohydrate-dose contrasts were imprecise
- Exploratory
Network structure
- Auxiliary network had two disconnected components
Original publication
Effects of a Low‐Carbohydrate Diet Combined With Exercise on HbA1c in Adults With Type 2 Diabetes: A Bayesian Multilevel Network and Dose–Response Meta‐Analysis. Diabetes Obes Metab. Published 30 September 2026. doi:10.
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