JAMA Intern Med

Sodium reduction drives BP drop in type 2 diabetes

June 12, 2025

For patients with T2DM—many already on antihypertensives—sodium reduction within a diabetes-tailored DASH diet offers a clinically meaningful, non-pharmacologic strategy to lower BP and potentially reduce CV risk.

Study details: The Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) randomized trial (NCT04286555) was a 4-period crossover feeding study conducted from June 2021 to June 2024. It enrolled 102 adults with T2DM and elevated systolic BP (120–159 mm Hg). Participants received all meals under controlled conditions, maintaining stable weight. Each participant followed four 5-week dietary interventions: a DASH-style diet optimized for diabetes (DASH4D) and a typical U.S. diet, each with both high and low sodium levels.

Results: Compared with the high-sodium typical U.S. diet, the DASH4D diet with reduced sodium significantly lowered systolic BP by 4.6 mm Hg (95% confidence interval [CI], 7.2-2.0; P < .001) and diastolic BP by 2.3 mm Hg 95% (CI, 3.7-0.9). Most of the BP reduction occurred within the first three weeks. Sodium reduction had a stronger effect than the DASH4D diet alone.

Source:

Pilla SJ, et al; DASH4D Collaborative Research Group. (2025, June 9). JAMA Intern Med. Dietary Patterns, Sodium Reduction, and Blood Pressure in Type 2 Diabetes: The DASH4D Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40489102/