Lifestyle modification and diabetic control

January 01, 0001

Lifestyle modification and diabetic control

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: [email protected]

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

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