Research Information System
ENDO2025, California, United States Of America, 12 - 15 July 2025, vol.9, no.9, pp.485, (Full Text)
Diabetes and Vascular Disease
MON-541 Nutrient Intake Order on Continuous Glucose Monitoring Parameters in Type 2 Diabetes: A Systematic Review and Meta-analysis
Luisa M Saldarriaga Callejas, MD1 , Piyush Ratan, MD2 , Eric Pasqualotto3 , Alberto Andrade, MD4 , Sena Kodalak, MD5 , and Talita Trevisan, MD6 1 Universidad CES, Medellín, Colombia; 2 Patna Medical College and Hospital, Patna, India; 3 Universidade Federal de Santa Catarina, Florianópolis, Brazil; 4 Loyola University Medical Center, Maywood, IL, USA; 5 Hacettepe University Hospital, Ankara, Turkey; 6 Private Practice, Itajaí, Brazil Disclosure: L. Saldarriaga Callejas: None. P. Ratan: None. E. Pasqualotto: None. A. Andrade: None. S. Kodalak: None. T. Trevisan: None.
Introduction and Objective: Continuous glucose monitoring (CGM) has emerged as a valuable tool in optimizing glycemic control for individuals with type 2 diabetes (T2D). However, integrating CGM data with evidence-based nutrition strategies remains a challenge, as many individuals struggle to interpret their glucoses profiles to make informed dietary choices. This study aims to evaluate the impact of a carbohydrate-last (CL) strategy compared to carbohydrate-first or unordered (CF) nutrient intake on CGM parameters in people with T2D. Methods: PubMed, EMBASE, and Cochrane Central were systematically searched for randomized controlled trials (RCTs) evaluating the impact of nutrient intake order on CGM data in T2D. Mean difference (MD) with 95% confidence interval (CI) was used for all outcomes. Heterogeneity was assessed with I² statistics. Statistical analyses were performed using RevMan Web. Results: Four studies involving 68 individuals were included, all of whom received both CL and CF in a crossover design. The mean age of participants ranged from 50 to 65.5 years, while the mean duration of diabetes varied between 4 and 16.4 years. The average body mass index ranged from 22.5 to 34.5 kg/m², and mean glycated hemoglobin levels were between 6.8% and 7.4%. In the pooled analysis, the CL group had significantly lower postprandial glucose at 120 minutes (MD: -18.59 mg/dL; 95% CI: -28.72, -8.47; p=0.0003). Mean glucose (MD: -6.49 mg/dL; 95% CI: -17.23, 4.25; p=0.24) and glycemic variability assessed using the coefficient of variation (MD: -1.11%; 95% CI: -4.31, 2.09; p=0.50) showed no significant differences. Conclusion: Carbohydrate-last nutrient intake is associated with improved postprandial glucose levels as measured by CGM in individuals with T2D. Larger, well-designed studies are needed to better assess this simple nutrient sequencing strategy on various glucose metrics. Presentation: Monday, July 14, 2025