SAT-525 Effects Of The Paleolithic Diet On Glycemic Control And Metabolic Health In Type 2 Diabetes: A Systematic Review

Abstract Disclosure: J. Panzan: None. B.S. Ribeiro: None. C.O. Neves: None. D.A. Silva: None. E.V. Braselino: None. H.R. Araujo: None. I.Z. Vitor: None. L.C. Souza: None. L.H. Graciolli: None. L.H. Castro: None. P. Clebis: None. T.K. Passos: None. Y.D. Moura: None. Effects of the Paleolithic Diet on Glycemic Control and Metabolic Health in Type 2 Diabetes: A Systematic ReviewIntroduction: The Paleolithic diet, inspired by ancestral dietary patterns, excludes cereals and dairy products and emphasizes lean meats, fruits, vegetables, and nuts. Unlike modern diets, which are rich in ultra-processed foods and linked to the rising incidence of obesity and type 2 diabetes (T2DM), the Paleolithic model has been proposed as a nutritional strategy to improve metabolic health. Current evidence suggests it may aid in weight loss, reduce insulin resistance, and improve glycemic control in individuals with T2DM. However, further investigation is needed to confirm its effectiveness and long-term safety. Methods: We conducted a systematic review following PRISMA guidelines. A comprehensive literature search was performed in the PubMed, Embase and Cochrane databases. Studies were included if they were randomized controlled trials published in the last five years, written in English, and evaluated the impact of the Paleolithic diet on glycemic outcomes in adults with type 2 diabetes. The main outcomes assessed included fasting blood glucose, HbA1c, insulin sensitivity, body weight, and related cardiovascular risk factors. After screening titles and abstracts, full texts were reviewed and six studies were selected for analysis. Results: A total of 95 patients with T2DM were followed for up to 12 weeks across the included studies. The Paleolithic diet was defined by unrestricted consumption of lean meats, fish, fruits, vegetables, nuts, and the exclusion of grains, dairy, legumes, sugar, and processed foods. Adherence to this diet led to reductions in body weight, BMI, fat mass, waist circumference, and systolic blood pressure. Significant improvements were also observed in glycemic control and insulin sensitivity. One study reported improved cardiorespiratory fitness and preservation of lean mass when the diet was combined with structured physical exercise. No serious adverse effects were reported, and adherence was generally high. While results were consistent across trials, variation in duration, dietary protocols, and participant characteristics limited comparability. Conclusion: This systematic review suggests that the Paleolithic diet may be a beneficial adjunct to conventional therapy in managing type 2 diabetes. Improvements in glycemic control, weight, and metabolic risk factors were observed within 12 weeks of intervention. The absence of serious adverse events reinforces its potential safety. However, larger and longer-term trials are warranted to establish sustainability, optimize adherence strategies, and validate long-term clinical outcomes. KW: Paleolithic diet; type 2 diabetes; metabolic health Presentation: Saturday, July 12, 2025