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DM: Carbohydrate Amount (2014)

Intervention
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of carbohydrate, independent of weight loss, on CVD risk factors (lipids or blood pressure)?
- Conclusion
  Two studies (one in adults with well-controlled type 1 diabetes; another in adults with well-controlled type 2 diabetes) regarding the relationship of differing amounts of carbohydrate (39% to 57% of energy), independent of weight loss, on CVD risk factors reported no significant effect on total cholesterol, LDL-cholesterol or blood pressure levels. Research regarding differing amounts of carbohydrate reports no significant effect on HDL-cholesterol and triglyceride levels in adults with type 1 diabetes, while decreased HDL-cholesterol and increased triglyceride levels were reported when consuming a higher-carbohydrate/lower-glycemic index/lower-fat diet in adults with type 2 diabetes.
  
  Subjects did not have or were not described as having any disorders of lipid metabolism or hypertension. Additional long-term studies are needed to ascertain the relationship of differing amounts of carbohydrate, independent of weight loss, on lipid profile in adults with diabetes, especially those with disorders of lipid metabolism and hypertension.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of carbohydrate, independent of weight loss, on CVD risk factors (lipids or blood pressure)?
- Search Plan and Results: DM: Carbohydrate Amount 2013
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of carbohydrate, independent of weight loss, on glycemia (A1C or glucose)?
- Conclusion
  Three studies regarding the relationship of differing amounts of carbohydrate (39% to 57% of energy), independent of weight loss, reported no significant effect on A1C in adults with type 1 and type 2 diabetes. One study in adults with type 2 diabetes reported a significantly higher fasting glucose and lower two-hour post-load glucose in subjects following a higher-carbohydrate/lower-glycemic index/lower-fat diet.
  
  Additional long-term studies are needed regarding the relationship of differing amounts of carbohydrate on glycemia in adults with diabetes.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of carbohydrate, independent of weight loss, on glycemia (A1C or glucose)?
- Search Plan and Results: DM: Carbohydrate Amount 2013
In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of carbohydrate, independent of weight loss, on insulin levels (exogenous or endogenous)?
- Conclusion
  Two studies regarding the relationship of differing amounts of carbohydrate (39% to 57% of energy), independent of weight loss, reported no significant effect on exogenous insulin doses in adults with well-controlled type 1 diabetes and no significant effect on endogenous insulin levels in adults with well-controlled type 2 diabetes.
  Additional long-term studies are needed regarding the relationship of differing amounts of carbohydrate on insulin levels in adults with diabetes.
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: In adults with type 1 and type 2 diabetes, what is the relationship of differing amounts of carbohydrate, independent of weight loss, on insulin levels (exogenous/endogenous)?
- Search Plan and Results: DM: Carbohydrate Amount 2013