Association of an almond-based low-carbohydrate diet with continuous glucose monitoring metrics in patients with type 2 diabetes mellitus: a randomized controlled trial.
- 1Department of Endocrinology and Metabolism, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui 230001, China.
- 2Department of Nursing, The Changshu Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215500, China. [email protected].
Abstract
Objective
To investigate the association between an almond-based low-carbohydrate diet (LCD) and continuous glucose monitoring (CGM) metrics in patients with type 2 diabetes mellitus (T2DM).Methods
This was a prospective randomized controlled study. Hospitalized patients with T2DM from Changshu No.1 People's Hospital were recruited from January 2022 to December 2022. 33 patients using CGM were included and randomly divided into the low-fat diet (LFD) group or the LCD with almonds group based on the random number table. Primary CGM metrics including time in range (TIR), time in tight range (TITR), time above range (TAR), time below range (TBR) were compared between the two groups. Linear regression analysis was performed to assess the association between diet group and nocturnal glycemic metrics.Results
Compared to LFD group, patients in the LCD with almonds group had higher nighttime TIR [98.51% (95.83, 99.88) vs. 91.67% (89.52, 98.07), P < 0.01] and TITR [94.14% (87.57, 98.41) vs. 77.58% (52.18, 90.58), P < 0.05]. Nighttime TAR [0.00% (0.00, 0.00) vs. 1.39% (0.00, 7.95), P < 0.01], HBGI [0.15 (0.01, 0.34) vs. 0.98 (0.08, 3.73), P < 0.05], and SD (15.57 ± 6.21 mg/dL vs. 23.62 ± 9.12 mg/dL, P < 0.05) were significantly lower in the LCD with almonds group. Multivariable regression demonstrated that LCD with almonds was independently associated with improvements in nocturnal TIR (β = 6.65%, P = 0.010) and TITR (β = 14.60%, P = 0.016) after adjustment for age, sex, and diabetes duration.Conclusion
The almond-based low-carbohydrate diet improved nocturnal glycemic control in patients with type 2 diabetes. These improvements in nocturnal TIR and TITR remained significant after multivariable adjustment for age, sex, and diabetes duration.Clinical trial registry
The study was registered at clinicaltrials.gov (registration no. ChiCTR2600116495).
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BibTeX
@article{li2026association,
title = {{Association of an almond-based low-carbohydrate diet with continuous glucose monitoring metrics in patients with type 2 diabetes mellitus: a randomized controlled trial.}},
author = {Xianming Li and Yanqin Xu and Xulin Wang and Yu Ding and Sihui Luo and Yu Gao},
journal = {Nutrition \& diabetes},
year = {2026},
month = jul,
doi = {10.1038/s41387-026-00456-4},
url = {https://europepmc.org/article/MED/42894020},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association of an almond-based low-carbohydrate diet with continuous glucose monitoring metrics in patients with type 2 diabetes mellitus: a randomized controlled trial.
AU - Xianming Li
AU - Yanqin Xu
AU - Xulin Wang
AU - Yu Ding
AU - Sihui Luo
AU - Yu Gao
PY - 2026
DA - 2026/07/01
JO - Nutrition & diabetes
DO - 10.1038/s41387-026-00456-4
UR - https://europepmc.org/article/MED/42894020
AB - Objective To investigate the association between an almond-based low-carbohydrate diet (LCD) and continuous glucose monitoring (CGM) metrics in patients with type 2 diabetes mellitus (T2DM).Methods This was a prospective randomized controlled study. Hospitalized patients with T2DM from Changshu No.1 People's Hospital were recruited from January 2022 to December 2022. 33 patients using CGM were included and randomly divided into the low-fat diet (LFD) group or the LCD with almonds group based on the random number table. Primary CGM metrics including time in range (TIR), time in tight range (TITR), time above range (TAR), time below range (TBR) were compared between the two groups. Linear regression analysis was performed to assess the association between diet group and nocturnal glycemic metrics.Results Compared to LFD group, patients in the LCD with almonds group had higher nighttime TIR [98.51% (95.83, 99.88) vs. 91.67% (89.52, 98.07), P < 0.01] and TITR [94.14% (87.57, 98.41) vs. 77.58% (52.18, 90.58), P < 0.05]. Nighttime TAR [0.00% (0.00, 0.00) vs. 1.39% (0.00, 7.95), P < 0.01], HBGI [0.15 (0.01, 0.34) vs. 0.98 (0.08, 3.73), P < 0.05], and SD (15.57 ± 6.21 mg/dL vs. 23.62 ± 9.12 mg/dL, P < 0.05) were significantly lower in the LCD with almonds group. Multivariable regression demonstrated that LCD with almonds was independently associated with improvements in nocturnal TIR (β = 6.65%, P = 0.010) and TITR (β = 14.60%, P = 0.016) after adjustment for age, sex, and diabetes duration.Conclusion The almond-based low-carbohydrate diet improved nocturnal glycemic control in patients with type 2 diabetes. These improvements in nocturnal TIR and TITR remained significant after multivariable adjustment for age, sex, and diabetes duration.Clinical trial registry The study was registered at clinicaltrials.gov (registration no. ChiCTR2600116495).
SN - 2044-4052
ER -