The Effect of Low Glycemic Load Diet on Central Obesity and Lipid Related Metabolic Abnormalities in T2DM Patients Is Comparable to That of Energy-Restricted Diet: A Randomized, Open, Parallel Controlled Study.

Type 2 diabetes mellitus (T2DM) is closely associated with central obesity, which further elevates cardiovascular disease risk. This randomized, open-label, parallel-controlled trial aimed to compare the effects of a low glycemic load (LGL) diet and a conventional energy-restricted diet on central obesity and lipid-related metabolic abnormalities in newly diagnosed T2DM patients following short-term intensive insulin therapy (SIIT). All participants received a 2-week course of SIIT before being randomly allocated to either the control group receiving a conventional energy-restricted diet (25-30 kcal/kg/day, with 45%-55% of energy from carbohydrates, 15%-20% from protein, and 25%-35% from fat) or an energy-matched LGL group with a target glycemic load of 56-68/1000 kcal. The 1-year dietary intervention was implemented with quarterly outcome assessments, and repeated-measures data were analyzed using generalized estimating equations via R 4.3.2. Between 2019 and 2023, a total of 366 patients were screened, and finally 89 eligible participants were enrolled, including 45 cases in the control group and 44 in the LGL group. During follow-up, significant intergroup differences were observed in dietary composition (GL/1000 kcal and macronutrient distribution) and changes in HbA1c. Energy intake, physical activity level (MET-h/week), body mass index, waist circumference, weight-corrected waist circumference, visceral adiposity index, and atherosclerosis index were all markedly reduced from baseline in both groups (p time < 0.05), while no significant between-group differences were detected for these indicators (p group > 0.05). In conclusion, the LGL diet and conventional energy-restricted diet exert comparable effects in improving central obesity and metabolic profiles among newly diagnosed T2DM patients after SIIT. Trial Registration: ChiCTR1900020559.