{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:41:50Z","timestamp":1792428110760,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nutr. Diabetes"],"DOI":"10.1038\/s41387-026-00456-4","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:03:42Z","timestamp":1784718222000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of an almond-based low-carbohydrate diet with continuous glucose monitoring metrics in patients with type 2 diabetes mellitus: a randomized controlled trial"],"prefix":"10.1038","volume":"16","author":[{"given":"Xianming","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xulin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1617-2125","authenticated-orcid":false,"given":"Yu","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihui","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2409-8440","authenticated-orcid":false,"given":"Yu","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"456_CR1","doi-asserted-by":"crossref","unstructured":"Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, et al. Global, Regional, and National Burden of Diabetes from 1990 to 2021, with Projections of Prevalence to 2050: a systematic analysis for the Global Burden of disease study 2021. Lancet. 2023;402:203\u201334.","DOI":"10.1016\/S0140-6736(23)01301-6"},{"key":"456_CR2","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.2337\/dci22-0034","volume":"45","author":"MJ Davies","year":"2022","unstructured":"Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (Ada) and the European Association for the Study of Diabetes (Easd). Diab Care. 2022;45:2753\u201386.","journal-title":"Diab Care"},{"key":"456_CR3","doi-asserted-by":"publisher","first-page":"k2234","DOI":"10.1136\/bmj.k2234","volume":"361","author":"NG Forouhi","year":"2018","unstructured":"Forouhi NG, Misra A, Mohan V, Taylor R, Yancy W. Dietary and nutritional approaches for prevention and management of type 2 diabetes. Bmj. 2018;361:k2234.","journal-title":"Bmj"},{"key":"456_CR4","doi-asserted-by":"publisher","first-page":"434","DOI":"10.2337\/dc11-2216","volume":"35","author":"ML Wheeler","year":"2012","unstructured":"Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J, et al. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010. Diab Care. 2012;35:434\u201345.","journal-title":"Diab Care"},{"key":"456_CR5","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1111\/dme.13603","volume":"35","author":"PA Dyson","year":"2018","unstructured":"Dyson PA, Twenefour D, Breen C, Duncan A, Elvin E, Goff L, et al. Diabetes Uk evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet Med. 2018;35:541\u20137.","journal-title":"Diabet Med"},{"key":"456_CR6","doi-asserted-by":"crossref","unstructured":"Gon\u00e7alves B, Pinto T, Aires A, Morais MC, Bacelar E, Anjos R, et al. Composition of nuts and their potential health benefits-an overview. Foods. 2023;12:942.","DOI":"10.3390\/foods12050942"},{"key":"456_CR7","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.numecd.2009.08.005","volume":"21","author":"P Casas-Agustench","year":"2011","unstructured":"Casas-Agustench P, L\u00f3pez-Uriarte P, Bull\u00f3 M, Ros E, Cabr\u00e9-Vila JJ, Salas-Salvad\u00f3 J. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2011;21:126\u201335.","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"456_CR8","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.1055923","volume":"9","author":"R Gayathri","year":"2022","unstructured":"Gayathri R, Abirami K, Kalpana N, Manasa VS, Sudha V, Shobana S, et al. Effect of almond consumption on insulin sensitivity and serum lipids among asian indian adults with overweight and obesity- a randomized controlled trial. Front Nutr. 2022;9:1055923.","journal-title":"Front Nutr"},{"key":"456_CR9","doi-asserted-by":"crossref","unstructured":"Wang LL, Wang Q, Hong Y, Ojo O, Jiang Q, Hou YY, et al. The effect of low-carbohydrate diet on glycemic control in patients with type 2 Diabetes Mellitus. Nutrients. 2018;10:661.","DOI":"10.3390\/nu10060661"},{"key":"456_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102797","volume":"90","author":"J Guo","year":"2020","unstructured":"Guo J, Long Q, Li J, Wang X, Li Y, Jiang S, et al. Barriers and facilitators of self-monitoring of blood glucose engagement among women with gestational Diabetes Mellitus in China: a mixed-methods study. Midwifery. 2020;90:102797.","journal-title":"Midwifery"},{"key":"456_CR11","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/S2213-8587(22)00319-9","volume":"11","author":"T Battelino","year":"2023","unstructured":"Battelino T, Alexander CM, Amiel SA, Arreaza-Rubin G, Beck RW, Bergenstal RM, et al. Continuous glucose monitoring and metrics for clinical trials: an international consensus statement. Lancet Diab Endocrinol. 2023;11:42\u201357.","journal-title":"Lancet Diab Endocrinol"},{"key":"456_CR12","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.2337\/dci19-0028","volume":"42","author":"T Battelino","year":"2019","unstructured":"Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diab Care. 2019;42:1593\u2013603.","journal-title":"Diab Care"},{"key":"456_CR13","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1038\/s41430-023-01263-1","volume":"77","author":"S Gulati","year":"2023","unstructured":"Gulati S, Misra A, Tiwari R, Sharma M, Pandey RM, Upadhyay AD, et al. Beneficial effects of premeal almond load on glucose profile on oral glucose tolerance and continuous glucose monitoring: randomized crossover trials in asian indians with prediabetes. Eur J Clin Nutr. 2023;77:586\u201395.","journal-title":"Eur J Clin Nutr"},{"key":"456_CR14","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1016\/j.metabol.2011.01.017","volume":"60","author":"AE Cohen","year":"2011","unstructured":"Cohen AE, Johnston CS. Almond ingestion at mealtime reduces postprandial glycemia and chronic ingestion reduces hemoglobin a(1c) in individuals with well-controlled type 2 diabetes mellitus. Metabolism. 2011;60:1312\u20137.","journal-title":"Metabolism"},{"key":"456_CR15","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1177\/19322968241267823","volume":"18","author":"B Kulzer","year":"2024","unstructured":"Kulzer B, Freckmann G, Ziegler R, Schnell O, Glatzer T, Heinemann L. Nocturnal hypoglycemia in the era of continuous glucose monitoring. J Diab Sci Technol. 2024;18:1052\u201360.","journal-title":"J Diab Sci Technol"},{"key":"456_CR16","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12986-017-0205-3","volume":"14","author":"CM Chen","year":"2017","unstructured":"Chen CM, Liu JF, Li SC, Huang CL, Hsirh AT, Weng SF, et al. Almonds ameliorate glycemic control in chinese patients with better controlled type 2 diabetes: a randomized, crossover, controlled feeding trial. Nutr Metab (Lond). 2017;14:51.","journal-title":"Nutr Metab (Lond)"},{"key":"456_CR17","doi-asserted-by":"publisher","first-page":"e002032","DOI":"10.1136\/bmjdrc-2020-002032","volume":"9","author":"M Martinez","year":"2021","unstructured":"Martinez M, Santamarina J, Pavesi A, Musso C, Umpierrez GE. Glycemic variability and cardiovascular disease in patients with type 2 diabetes. BMJ Open Diab Res. Care. 2021;9:e002032.","journal-title":"BMJ Open Diab Res. Care."},{"key":"456_CR18","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13098-019-0425-y","volume":"11","author":"M Ohara","year":"2019","unstructured":"Ohara M, Kohata Y, Nagaike H, Koshibu M, Gima H, Hiromura M, et al. Association of glucose and blood pressure variability on oxidative stress in patients with type 2 diabetes mellitus and hypertension: a cross-sectional study. Diabetol Metab Syndr. 2019;11:29.","journal-title":"Diabetol Metab Syndr"},{"key":"456_CR19","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.metabol.2010.04.009","volume":"60","author":"SC Li","year":"2011","unstructured":"Li SC, Liu YH, Liu JF, Chang WH, Chen CM, Chen CY. Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. Metabolism. 2011;60:474\u20139.","journal-title":"Metabolism"},{"key":"456_CR20","doi-asserted-by":"publisher","first-page":"e2221","DOI":"10.1210\/clinem\/dgac034","volume":"107","author":"M Yapanis","year":"2022","unstructured":"Yapanis M, James S, Craig ME, O\u2019Neal D, Ekinci EI. Complications of diabetes and metrics of glycemic management derived from continuous glucose monitoring. J Clin Endocrinol Metab. 2022;107:e2221\u201336.","journal-title":"J Clin Endocrinol Metab"},{"key":"456_CR21","first-page":"1419","volume":"6","author":"DP Singh","year":"2025","unstructured":"Singh DP, Upadhyay A, Kumar A. Wearable continuous glucose monitoring\u2013derived glycemic variability as a predictor of microvascular complications in type 2 diabetes mellitus: a prospective cohort study. Int J Med Pharm Res. 2025;6:1419\u201325.","journal-title":"Int J Med Pharm Res"},{"key":"456_CR22","doi-asserted-by":"publisher","first-page":"1746s","DOI":"10.1093\/jn\/138.9.1746S","volume":"138","author":"PM Kris-Etherton","year":"2008","unstructured":"Kris-Etherton PM, Hu FB, Ros E, Sabat\u00e9 J. The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms. J Nutr. 2008;138:1746s\u201351s.","journal-title":"J Nutr"},{"key":"456_CR23","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1007\/s11883-010-0132-5","volume":"12","author":"E Ros","year":"2010","unstructured":"Ros E, Tapsell LC, Sabat\u00e9 J. Nuts and berries for heart health. Curr Atheroscler Rep. 2010;12:397\u2013406.","journal-title":"Curr Atheroscler Rep"},{"key":"456_CR24","doi-asserted-by":"crossref","unstructured":"Ren M, Zhang H, Qi J, Hu A, Jiang Q, Hou Y, et al. An almond-based low carbohydrate diet improves depression and glycometabolism in patients with type 2 diabetes through modulating gut microbiota and Glp-1: a randomized controlled trial. Nutrients. 2020;12:3036.","DOI":"10.3390\/nu12103036"},{"key":"456_CR25","doi-asserted-by":"publisher","first-page":"123s","DOI":"10.1093\/ajh\/6.4S.123S","volume":"6","author":"LM Resnick","year":"1993","unstructured":"Resnick LM. Ionic basis of hypertension, insulin resistance, vascular disease, and related disorders. The mechanism of \u201cSyndrome X. Am J Hypertens. 1993;6:123s\u2013134s.","journal-title":"Am J Hypertens"},{"key":"456_CR26","doi-asserted-by":"publisher","DOI":"10.1038\/s41545-022-00207-9","volume":"5","author":"WI Albaker","year":"2022","unstructured":"Albaker WI, Al-Hariri MT, Al Elq AH, Alomair NA, Alamoudi AS, Voutchkov N, et al. Beneficial effects of adding magnesium to desalinated drinking water on metabolic and insulin resistance parameters among patients with type 2 diabetes mellitus: a randomized controlled clinical trial. NPJ Clean Water. 2022;5:63.","journal-title":"NPJ Clean Water"},{"key":"456_CR27","doi-asserted-by":"crossref","unstructured":"Veronese N, Dominguez LJ, Pizzol D, Demurtas J, Smith L, Barbagallo M. Oral magnesium supplementation for treating glucose metabolism parameters in people with or at risk of diabetes: a systematic review and meta-analysis of double-blind randomized controlled trials. Nutrients. 2021;13:4074.","DOI":"10.3390\/nu13114074"},{"key":"456_CR28","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1016\/j.numecd.2014.04.001","volume":"24","author":"SK Nishi","year":"2014","unstructured":"Nishi SK, Kendall CW, Bazinet RP, Bashyam B, Ireland CA, Augustin LS, et al. Nut consumption, serum fatty acid profile and estimated coronary heart disease risk in type 2 diabetes. Nutr Metab Cardiovasc Dis. 2014;24:845\u201352.","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"456_CR29","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/dom.13060","volume":"20","author":"OM Farr","year":"2018","unstructured":"Farr OM, Tuccinardi D, Upadhyay J, Oussaada SM, Mantzoros CS. Walnut consumption increases activation of the insula to highly desirable food cues: a randomized, double-blind, placebo-controlled, cross-over Fmri study. Diab Obes Metab. 2018;20:173\u20137.","journal-title":"Diab Obes Metab"},{"key":"456_CR30","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jnutbio.2017.04.002","volume":"45","author":"P Hern\u00e1ndez-Alonso","year":"2017","unstructured":"Hern\u00e1ndez-Alonso P, Ca\u00f1ueto D, Giardina S, Salas-Salvad\u00f3 J, Ca\u00f1ellas N, Correig X, et al. Effect of Pistachio consumption on the modulation of urinary gut microbiota-related metabolites in prediabetic subjects. J Nutr Biochem. 2017;45:48.","journal-title":"J Nutr Biochem"}],"container-title":["Nutrition &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41387-026-00456-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41387-026-00456-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41387-026-00456-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:02:28Z","timestamp":1792425748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41387-026-00456-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["456"],"URL":"https:\/\/doi.org\/10.1038\/s41387-026-00456-4","relation":{},"ISSN":["2044-4052"],"issn-type":[{"value":"2044-4052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"2 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Approval of the research protocol: The institutional review board approved the study protocol at The Changshu Affiliated Hospital of Soochow University (Approval No. 202128). It is consistent with the provisions of the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"49"}}