Early intensive diet intervention can improve glycaemic control in type 2 diabetes

January 01, 0001

Early intensive diet intervention can improve glycaemic control in type 2 diabetes

Lifestyle changes soon after diagnosis might improve outcomes in patients with type 2 diabetes mellitus, but no large trials have compared interventions. The researchers from the UK investigated the effects of diet and physical activity on blood pressure and glucose concentrations. They did a randomised, controlled trial in southwest England in adults aged 30—80 years in whom type 2 diabetes had been diagnosed 5—8 months previously. Participants were assigned usual care (initial dietary consultation and follow-up every 6 months; control group), an intensive diet intervention (dietary consultation every 3 months with monthly nurse support), or the latter plus a pedometer-based activity programme, in a 2:5:5 ratio. Of 593 eligible individuals, 99 were assigned usual care, 248 the diet regimen, and 246 diet plus activity. Outcome data were available for 99% and 98% participants at 6 and 12 months, respectively.

At 6 months, glycaemic control had worsened in the control group (mean baseline HbA1c percentage 6.72 and at 6 months 6.86) but improved in the diet group (baseline-adjusted difference in percentage of HbA1c -0.28%) and diet plus activity group (-0.33%). These differences persisted to 12 months, despite less use of diabetes drugs. Improvements were also seen in bodyweight and insulin resistance between the intervention and control groups. Blood pressure was similar in all groups.

The researchers concluded: "An intensive diet intervention soon after diagnosis can improve glycaemic control. The addition of an activity intervention conferred no additional benefit."

So, dietary consultations at 3 and 6 months, but can we achieve this outcome in a non-study group?

For the full abstract, click here.

The Lancet published online 25 June 2011 © 2011 Elsevier Limited
Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial. RC Andrews, AR Cooper, AA Montgomery et al. Correspondence to Rob Andrews: [email protected]

Category: T. Endocrine/Metabolic/Nutritional. Keywords: diet, physical activity, type 2 diabetes, newly diagnosed, randomised controlled trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 12 July 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.