Association of Almond-Based Low-Carbohydrate Diet with Continuous Glucose Monitoring Metrics in Patients with Type 2 Diabetes Mellitus

A prospective randomized controlled study was conducted to investigate the association between an almond-based low-carbohydrate diet and continuous glucose monitoring (CGM) metrics in patients with type 2 diabetes mellitus (T2DM). The study recruited hospitalized patients with T2DM from Changshu No.1 People’s Hospital from January 2022 to December 2022. A total of 33 patients using CGM were included and randomly divided into two groups: a low-fat diet (LFD) group and an almond-based low-carbohydrate diet (LCD) with almonds group. The primary CGM metrics, including time in range (TIR), time in tight range (TITR), time above range (TAR), and 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. The results showed that patients in the LCD with almonds group had higher nighttime TIR and TITR compared to the LFD group. Notably, the LCD with almonds group also had lower nighttime TAR, HbA1c, and standard deviation (SD) of glucose levels. Multivariable regression analysis demonstrated that the LCD with almonds was independently associated with improvements in nocturnal TIR and TITR after adjustment for age, sex, and diabetes duration. These findings suggest that an almond-based low-carbohydrate diet may improve nocturnal glycemic control in patients with type 2 diabetes. The study was registered at clinicaltrials.gov (registration no. ChiCTR2600116495).