These New Zealand researchers examined whether intensive dietary intervention affects glycemic control in uncontrolled diabetics who are on multiple diabetic medications. They performed a randomized controlled trial involving 93 type 2 diabetics and a HbA1c of more than 7% despite optimised drug treatments plus also wereoverweight or obese, had hypertension, and/or hyperlipidemia. The intervention consisted of intensive individualized dietary advice for six months. Both the intervention and control participants continued with their usual medical surveillance.
The authors found: "After adjustment for age, sex, and baseline measurements, the difference in HbA1c between the intervention and control groups at six months (-0.4) was highly statistically significant, as were the decreases in weight (-1.3 kg), body mass index (-0.5), and waist circumference (-1.6 cm). A decrease in saturated fat (-1.9% total energy) and an increase in protein (1.6% total energy) in the intervention group were the most striking differences in nutritional intake between the two groups."
The authors concluded: "Intensive dietary advice has the potential to appreciably improve glycaemic control and anthropometric measures in patients with type 2 diabetes and unsatisfactory HbA1c despite optimised hypoglycaemic drug treatment."
This study demonstrates that lifestyle modification in the form of dietary advice can have at least a modest benefit in uncontrolled diabetics who are uncontrolled despite medication management.
For the full abstract, click here.
BMJ 341:c3337, 20 July 2010 © 2010 Coppell et al.
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, Minako Kataoka, Sheila M Williams, Alex W Chisholm, Sue M Vorgers, and Jim I Mann. Correspondence to K Coppell: kirsten.coppell@otago.ac.nz
Category: T. Endocrine/Metabolic/Nutritional. Keywords: diabetes, dietary intervention, uncontrolled, hypoglycemic medications, LOADD, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 3 August 2010
