Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment--Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial - PubMed (original) (raw)
Randomized Controlled Trial
Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment--Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial
Kirsten J Coppell et al. BMJ. 2010.
Abstract
Objective: To determine the extent to which intensive dietary intervention can influence glycaemic control and risk factors for cardiovascular disease in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment.
Design: Randomised controlled trial.
Setting: Dunedin, New Zealand.
Participants: 93 participants aged less than 70 years with type 2 diabetes and a glycated haemoglobin (HbA(1c)) of more than 7% despite optimised drug treatments plus at least two of overweight or obesity, hypertension, and dyslipidaemia.
Intervention: Intensive individualised dietary advice (according to the nutritional recommendations of the European Association for the Study of Diabetes) for six months; both the intervention and control participants continued with their usual medical surveillance.
Main outcome measures: HbA(1c) was the primary outcome. Secondary outcomes included measures of adiposity, blood pressure, and lipid profile.
Results: After adjustment for age, sex, and baseline measurements, the difference in HbA(1c) between the intervention and control groups at six months (-0.4%, 95% confidence interval -0.7% to -0.1%) was highly statistically significant (P=0.007), as were the decreases in weight (-1.3 kg, -2.4 to -0.1 kg; P=0.032), body mass index (-0.5, -0.9 to -0.1; P=0.026), and waist circumference (-1.6 cm, -2.7 to -0.5 cm; P=0.005). A decrease in saturated fat (-1.9% total energy, -3.3% to -0.6%; P=0.006) and an increase in protein (1.6% total energy, 0.04% to 3.1%; P=0.045) in the intervention group were the most striking differences in nutritional intake between the two groups.
Conclusions: Intensive dietary advice has the potential to appreciably improve glycaemic control and anthropometric measures in patients with type 2 diabetes and unsatisfactory HbA(1c) despite optimised hypoglycaemic drug treatment.
Trial registration: Clinical trials NCT00124553.
Conflict of interest statement
Competing interests: All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi\_disclosure.pdf (available on request from the corresponding author) and declare: (1) No financial support for the submitted work from anyone other than their employer; (2) No financial relationships with commercial entities that might have an interest in the submitted work; (3) No spouses, partners, or children with relationships with commercial entities that might have an interest in the submitted work; (4) No non-financial interests that may be relevant to the submitted work.
Figures
Flow chart of participants.
Comment in
- Nutrition in people with poorly controlled type 2 diabetes.
Clifton P. Clifton P. BMJ. 2010 Jul 20;341:c3393. doi: 10.1136/bmj.c3393. BMJ. 2010. PMID: 20647286 No abstract available. - Nutrition in type 2 diabetes. Metabolic surgery may be more effective.
Magee C, Goenka N, Kerrigan D. Magee C, et al. BMJ. 2010 Aug 19;341:c4446. doi: 10.1136/bmj.c4446. BMJ. 2010. PMID: 20724409 No abstract available. - Intensive dietary advice significantly improves HbA(1c) in patients with type II diabetes who remain hyperglycaemic despite optimised drug treatment.
Wexler DJ, Grant RW. Wexler DJ, et al. Evid Based Med. 2010 Dec;15(6):179-80. doi: 10.1136/ebm1139. Epub 2010 Sep 22. Evid Based Med. 2010. PMID: 20861408 No abstract available.
Similar articles
- A randomised, controlled trial of self-monitoring of blood glucose in patients with type 2 diabetes receiving conventional insulin treatment.
Nauck MA, Haastert B, Trautner C, Müller UA, Nauck MA, Heinemann L; Clinical Trials Study Group of the German Association for the Study of Diabetes (Deutsche Diabetes-Gesellschaft). Nauck MA, et al. Diabetologia. 2014 May;57(5):868-77. doi: 10.1007/s00125-014-3168-1. Epub 2014 Jan 21. Diabetologia. 2014. PMID: 24445534 Clinical Trial. - Repaglinide : a pharmacoeconomic review of its use in type 2 diabetes mellitus.
Plosker GL, Figgitt DP. Plosker GL, et al. Pharmacoeconomics. 2004;22(6):389-411. doi: 10.2165/00019053-200422060-00005. Pharmacoeconomics. 2004. PMID: 15099124 Review. - Glycaemic impact of patient-led use of sensor-guided pump therapy in type 1 diabetes: a randomised controlled trial.
O'Connell MA, Donath S, O'Neal DN, Colman PG, Ambler GR, Jones TW, Davis EA, Cameron FJ. O'Connell MA, et al. Diabetologia. 2009 Jul;52(7):1250-7. doi: 10.1007/s00125-009-1365-0. Epub 2009 Apr 25. Diabetologia. 2009. PMID: 19396424 Clinical Trial. - Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis.
Karagiannis T, Paschos P, Paletas K, Matthews DR, Tsapas A. Karagiannis T, et al. BMJ. 2012 Mar 12;344:e1369. doi: 10.1136/bmj.e1369. BMJ. 2012. PMID: 22411919 - Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin.
Malanda UL, Welschen LM, Riphagen II, Dekker JM, Nijpels G, Bot SD. Malanda UL, et al. Cochrane Database Syst Rev. 2012 Jan 18;1:CD005060. doi: 10.1002/14651858.CD005060.pub3. Cochrane Database Syst Rev. 2012. PMID: 22258959 Review.
Cited by
- Efficacy of Save Medical Corporation (SMC)-01, a Smartphone App Designed to Support Type 2 Diabetes Self-Management Based on Established Guidelines: Randomized Controlled Trial.
Leung N, Waki K, Nozoe S, Enomoto S, Saito R, Hamagami S, Yamauchi T, Nangaku M, Ohe K, Onishi Y. Leung N, et al. J Med Internet Res. 2024 Sep 10;26:e53740. doi: 10.2196/53740. J Med Internet Res. 2024. PMID: 39255478 Free PMC article. Clinical Trial. - Calorie Restriction Using High-Fat/Low-Carbohydrate Diet Suppresses Liver Fat Accumulation and Pancreatic Beta-Cell Dedifferentiation in Obese Diabetic Mice.
Lei X, Ishida E, Yoshino S, Matsumoto S, Horiguchi K, Yamada E. Lei X, et al. Nutrients. 2024 Mar 28;16(7):995. doi: 10.3390/nu16070995. Nutrients. 2024. PMID: 38613031 Free PMC article. - EVALUATION OF THE RELATIONSHIP BETWEEN MEDICAL NUTRITION TREATMENT, PENTRAXIN-3, HSCRP AND BODY COMPOSITION ANALYSIS IN TYPE 2 DIABETIC PATIENTS.
Duran R, Marakoğlu K, Vatansev H, Kizmaz M, Saraçligil B, Aybatti E, Demirci V, Kebapcilar L. Duran R, et al. Acta Endocrinol (Buchar). 2023 Apr-Jun;19(2):169-177. doi: 10.4183/aeb.2023.169. Epub 2023 Oct 27. Acta Endocrinol (Buchar). 2023. PMID: 37908879 Free PMC article. - Effect of Dietary Approaches on Glycemic Control in Patients with Type 2 Diabetes: A Systematic Review with Network Meta-Analysis of Randomized Trials.
Jing T, Zhang S, Bai M, Chen Z, Gao S, Li S, Zhang J. Jing T, et al. Nutrients. 2023 Jul 15;15(14):3156. doi: 10.3390/nu15143156. Nutrients. 2023. PMID: 37513574 Free PMC article. Review. - Dietary advice in diabetes mellitus.
Tan YQ, Tan ZE, Tan YL, How CH. Tan YQ, et al. Singapore Med J. 2023 May;64(5):326-329. doi: 10.4103/singaporemedj.SMJ-2022-004. Singapore Med J. 2023. PMID: 37203129 Free PMC article. No abstract available.
References
- Mann JI, De Leeuw I, Hermansen K, Karamanos B, Karlström B, Katsilambros N, et al. Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus. Nutr Metab Cardiovasc Dis 2004;14:373-94. - PubMed
- Ary DV, Toobert D, Wilson W, Glasgow RE. Patient perspective on factors contributing to nonadherence to diabetes regimen. Diabetes Care 1986;9:168-72. - PubMed
- Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs 2005;65:385-411. - PubMed
- Eliasson B, Eeg-Olofsson K, Cederholm J, Nilsson PM, Gudbjörnsdóttir S, for the Steering Committee of the Swedish National Diabetes Register (NDR). Antihyperglycaemic treatment of type 2 diabetes: results from a national diabetes register. Diabetes Metab 2007;33:269-76. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous