Intervention Effects of Optimized Carbohydrate Diet in Patients With Type 2 Diabetes

Exclusion Criteria

• •1. Treatment with insulin
• •2. Treatment with GLP-1 receptor agonists or DPP-4 inhibitors
• •3. Occurrence of diabetic ketoacidosis, lactic acidosis, hyperosmolar coma, or recurrent severe hypoglycemia within the past year
• •4. Having one or more severe chronic diabetic complications, including advanced diabetic retinopathy, macroalbuminuria (urine albumin-to-creatinine ratio ≥300 mg/g), or impaired renal function (eGFR ≤60 ml/min/1.73 m²)
• •5. Presence of cardiovascular events (e.g., myocardial infarction, stent placement, unstable angina, heart failure, cardiac dysfunction) or cerebrovascular diseases (e.g., intracerebral hemorrhage, ischemic stroke) within the past 6 months
• •6. Diagnosis of acute or chronic gastrointestinal diseases (e.g., ulcers), hyperthyroidism or hypothyroidism, uncontrolled hypertension, active malignancy not in remission, or other life-threatening diseases
• •7. Recent use of antibiotics, probiotics, or prebiotics within the past 3 weeks or need for long-term use
• •8. Unstable medication regimen or use of prescription medications affecting metabolism (e.g., thyroid hormones, glucocorticoids)
• •9. Pregnancy, breastfeeding, or planning pregnancy
• •10. Presence of a pacemaker or metal implants, claustrophobia, or other contraindications to fMRI
• •11. Psychiatric disorders impairing cooperation
• •12. Expected poor compliance
• •13. Current or recent (within 4 weeks prior to study initiation) participation in other clinical trials