SALT IN DIABETICS

Primary research question: To evaluate the effect of altered salt intake on blood pressure and markers of cardiovascular disease and chronic kidney disease in people with diabetes.

Study design: Systematic review of randomized controlled trials

Population

Number of patients studied: 313
Inclusion criteria: Individuals with type 1 or type 2 diabetes, difference between low and high sodium intakes of at least 34 mmol/day
Exclusion criteria: Studies that did not meet the inclusion criteria, had insufficient data, or were not randomized controlled trials

Interventions

Experimental group: Reduced sodium intake
Control group: Usual or higher sodium intake

Primary outcome

Significant difference? Yes

Secondary outcomes: Glomerular filtration rate (GFR), HbA1c, and body weight

Safety outcomes or Adverse Events: Postural hypotension in one study (11% on low-salt diet, 21% on low-salt diet combined with hydrochlorothiazide)

Conclusion

Reducing salt intake in people with diabetes and normal GFR leads to a significant reduction in blood pressure, which supports international recommendations of reducing salt intake to less than 5 g/day (2 g sodium) for individuals with diabetes.

Heerspink, H. J. L., Ninomiya, T., Zoungas, S., de Zeeuw, D., Grobbee, D. E., Jardine, M. J., ... & Neal, B. (2012). Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. The Lancet, 379(9818), 1005-1012.