The difficulty of nutritional management of type 2 diabetes mellitus (T2DM) in primary health care in Brazil highlight the need for innovative strategies based on nutritional education. This study evaluated the effectiveness of an online educational intervention based on a low-carbohydrate diet for adults with T2DM and compared with conventional primary care management. A 16-week parallel randomized clinical trial enrolled 58 non-insulin users (mean age: 61 years), randomized to an Intervention (n = 29) or Control group (CG) (n = 29). After 16 weeks, the Intervention Group (IG) showed significant reductions in HbA1c (− 0.91 ± 0.16%), fasting glucose (− 1.46 ± 0.06 mmol/L) and BMI (− 1.63 ± 0.8 kg/m²). In contrast, the CG exhibited significant increases in fasting glucose (+ 1.03 ± 0.17 mmol/L) and Body Mass index (+ 0.96 ± 0.5 kg/m2), with no significant HbA1c change (+ 0.25 ± 0.04%). Between-group comparisons favored the IG (p < 0.001), with net differences of 1.17% in HbA1c and 27.5% in fasting glucose. Additionally, 31% of IG participants achieved HbA1c ≤ 6.5%, whereas none of the CG participants achieved the HbA1c target. Use of oral antidiabetic medication decreased significantly in the IG; notably, this reduction was not observed in the CG (44.8% vs. 0%, p < 0.001). In conclusion, the online education intervention improved glycemic control, reduced BMI, and lowered medication requirements, representing a promising strategy for T2DM management with potential to reduce complications and healthcare system costs.
Balbinot et al. (2026) studied this question.