Carbohydrate Intake Ratio and Diabetes Risk in Asians: An Evidence‑Based Table and Clinical Perspectives

Due to inherently lower insulin secretory capacity and a diet high in refined, high-glycemic index carbohydrates, Asian populations exhibit a significant positive association between high carbohydrate intake and diabetes risk. This article compiles recent large-scale Asian cohort studies and clinical guidelines, dividing carbohydrate intake (% of total daily calories) into five intervals (<26%, 26–44%, 45–60%, 60–75%, 65–80%). Key findings include: long-term risk increased by 222.8% with 65–80% carbohydrate intake (25-year follow-up); Asian-specific risk increased by 29% in the 60–75% range; the 45–60% range showed a hyperglycemia prevalence of 37%; reducing carbohydrate intake to 43% lowered risk by 30%; a low-carbohydrate diet (<26% of total calories) significantly improved HbA1c by 1.6% over 6–18 months. For high-risk groups (family history of diabetes/metabolic syndrome/prediabetes/MASLD/obesity with BMI >25), we recommend actively reducing carbohydrate intake to 26–44%, or even to <26% in the short term, to lower diabetes risk and promote remission. This preprint compiles evidence from recent large-scale Asian cohort studies and provides clinical perspectives on carbohydrate intake ratios for diabetes risk reduction in Asian populations, with a special focus on an evidence-based risk table and the "FEED ATOMS" behavioral model. This article represents the author's evidence-based perspectives and is not intended as formal clinical guidelines. Readers should consult healthcare professionals for individual medical advice. Version: 9.0 (Preprint) Upload date: May.29.2026