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A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial

BACKGROUND/OBJECTIVES: In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges of acces...

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Autores principales: Dening, Jedha, Mohebbi, Mohammadreza, Abbott, Gavin, George, Elena S., Ball, Kylie, Islam, Sheikh Mohammed Shariful
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460437/
https://www.ncbi.nlm.nih.gov/pubmed/37633959
http://dx.doi.org/10.1038/s41387-023-00240-8
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author Dening, Jedha
Mohebbi, Mohammadreza
Abbott, Gavin
George, Elena S.
Ball, Kylie
Islam, Sheikh Mohammed Shariful
author_facet Dening, Jedha
Mohebbi, Mohammadreza
Abbott, Gavin
George, Elena S.
Ball, Kylie
Islam, Sheikh Mohammed Shariful
author_sort Dening, Jedha
collection PubMed
description BACKGROUND/OBJECTIVES: In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges of accessibility and availability of dietary education and support for T2DM. No previous study had evaluated a web-based LCD intervention using a randomised controlled trial (RCT) design. The objective of this study was to assess whether a web-based LCD programme provided in conjunction with standard care improves glycaemic control in adults with T2DM. SUBJECTS/METHODS: A 16-week parallel RCT was conducted remotely during Covid-19 among the general community, recruiting adults with T2DM not on insulin aged 40–89 years. Participants were randomly assigned (1:1) to standard care plus the web-based T2Diet healthy LCD education programme (intervention) or standard care only (control). The primary outcome was haemoglobin A1c (HbA1c). Secondary outcomes were weight, body mass index (BMI), anti-glycaemic medication, dietary intake, and self-efficacy. Blinded data analysis was conducted by intention-to-treat. RESULTS: Ninety-eight participants were enrolled, assigning 49 to each group, with 87 participants (n = 40 intervention; n = 47 control) included in outcome analysis. At 16 weeks, there was a statistically significant between-group difference favouring the intervention group, with reductions in HbA1c –0.65% (95% CI: –0.99 to –0.30; p < 0.0001), weight –3.26 kg (p < 0.0001), BMI –1.11 kg/m(2) (p < 0.0001), and anti-glycaemic medication requirements –0.40 (p < 0.0001), with large effect sizes Cohen’s d > 0.8. CONCLUSION: This study demonstrated that as an adjunct to standard care, the web-based T2Diet programme significantly improved glycaemic control and clinical outcomes in adults with T2DM. In addition, the results highlight the potential to improve access and availability for people with T2DM to achieve glycaemic control and improved health through web-based dietary education and support.
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spelling pubmed-104604372023-08-28 A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial Dening, Jedha Mohebbi, Mohammadreza Abbott, Gavin George, Elena S. Ball, Kylie Islam, Sheikh Mohammed Shariful Nutr Diabetes Article BACKGROUND/OBJECTIVES: In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges of accessibility and availability of dietary education and support for T2DM. No previous study had evaluated a web-based LCD intervention using a randomised controlled trial (RCT) design. The objective of this study was to assess whether a web-based LCD programme provided in conjunction with standard care improves glycaemic control in adults with T2DM. SUBJECTS/METHODS: A 16-week parallel RCT was conducted remotely during Covid-19 among the general community, recruiting adults with T2DM not on insulin aged 40–89 years. Participants were randomly assigned (1:1) to standard care plus the web-based T2Diet healthy LCD education programme (intervention) or standard care only (control). The primary outcome was haemoglobin A1c (HbA1c). Secondary outcomes were weight, body mass index (BMI), anti-glycaemic medication, dietary intake, and self-efficacy. Blinded data analysis was conducted by intention-to-treat. RESULTS: Ninety-eight participants were enrolled, assigning 49 to each group, with 87 participants (n = 40 intervention; n = 47 control) included in outcome analysis. At 16 weeks, there was a statistically significant between-group difference favouring the intervention group, with reductions in HbA1c –0.65% (95% CI: –0.99 to –0.30; p < 0.0001), weight –3.26 kg (p < 0.0001), BMI –1.11 kg/m(2) (p < 0.0001), and anti-glycaemic medication requirements –0.40 (p < 0.0001), with large effect sizes Cohen’s d > 0.8. CONCLUSION: This study demonstrated that as an adjunct to standard care, the web-based T2Diet programme significantly improved glycaemic control and clinical outcomes in adults with T2DM. In addition, the results highlight the potential to improve access and availability for people with T2DM to achieve glycaemic control and improved health through web-based dietary education and support. Nature Publishing Group UK 2023-08-27 /pmc/articles/PMC10460437/ /pubmed/37633959 http://dx.doi.org/10.1038/s41387-023-00240-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Dening, Jedha
Mohebbi, Mohammadreza
Abbott, Gavin
George, Elena S.
Ball, Kylie
Islam, Sheikh Mohammed Shariful
A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
title A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
title_full A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
title_fullStr A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
title_full_unstemmed A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
title_short A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
title_sort web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the t2diet study randomised controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460437/
https://www.ncbi.nlm.nih.gov/pubmed/37633959
http://dx.doi.org/10.1038/s41387-023-00240-8
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