title: A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses.
abstract: OBJECTIVE
  To summarise the evidence about the efficacy of a Mediterranean diet on the management of type 2 diabetes and prediabetic states.
  
  
  METHODS
  A systematic review of all meta-analyses and randomised controlled trials (RCTs) that compared the Mediterranean diet with a control diet on the treatment of type 2 diabetes and prediabetic states was conducted. Electronic searches were carried out up to January 2015. Trials were included for meta-analyses if they had a control group treated with another diet, if they were of sufficient duration (at least 6 months), and if they had at least 30 participants in each arm. A random-effect model was used to pool data.
  
  
  METHODS
  Adults with or at risk for type 2 diabetes.
  
  
  METHODS
  Dietary patterns that described themselves as using a 'Mediterranean' dietary pattern.
  
  
  METHODS
  The outcomes were glycaemic control, cardiovascular risk factors and remission from the metabolic syndrome.
  
  
  RESULTS
  From 2824 studies, 8 meta-analyses and 5 RCTs were eligible. A 'de novo' meta-analysis of 3 long-term (>6 months) RCTs of the Mediterranean diet and glycaemic control of diabetes favoured the Mediterranean diet as compared with lower fat diets. Another 'de novo' meta-analysis of two long-term RCTs showed a 49% increased probability of remission from the metabolic syndrome. 5 meta-analyses showed a favourable effect of the Mediterranean diet, as compared with other diets, on body weight, total cholesterol and high-density lipoprotein cholesterol. 2 meta-analyses demonstrated that higher adherence to the Mediterranean diet reduced the risk of future diabetes by 19-23%.
  
  
  CONCLUSIONS
  The Mediterranean diet was associated with better glycaemic control and cardiovascular risk factors than control diets, including a lower fat diet, suggesting that it is suitable for the overall management of type 2 diabetes.
authors.affiliation: Diabetes Unit, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Katherine
authors.initials: K
authors.lastname: Esposito
authors.affiliation: Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Naples, Italy.
authors.forename: Maria Ida
authors.initials: MI
authors.lastname: Maiorino
authors.affiliation: Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellastella
authors.affiliation: Medical Statistics Unit, Second University of Naples, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiodini
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Panagiotakos
authors.affiliation: Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Second University of Naples, Naples, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Giugliano
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D038441:Diet, Mediterranean; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL
keywords: DIABETES & ENDOCRINOLOGY; NUTRITION & DIETETICS; PREVENTIVE MEDICINE