Cargando…
Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial
BACKGROUND: Dietary modifications are crucial for managing newly diagnosed type 2 diabetes mellitus (T2DM) and preventing its health complications, but many patients fail to achieve clinical goals with diet alone. We sought to evaluate the clinical effects of a personalized postprandial-targeting (P...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826661/ https://www.ncbi.nlm.nih.gov/pubmed/35135549 http://dx.doi.org/10.1186/s12916-022-02254-y |
_version_ | 1784647472652484608 |
---|---|
author | Rein, Michal Ben-Yacov, Orly Godneva, Anastasia Shilo, Smadar Zmora, Niv Kolobkov, Dmitry Cohen-Dolev, Noa Wolf, Bat-Chen Kosower, Noa Lotan-Pompan, Maya Weinberger, Adina Halpern, Zamir Zelber-Sagi, Shira Elinav, Eran Segal, Eran |
author_facet | Rein, Michal Ben-Yacov, Orly Godneva, Anastasia Shilo, Smadar Zmora, Niv Kolobkov, Dmitry Cohen-Dolev, Noa Wolf, Bat-Chen Kosower, Noa Lotan-Pompan, Maya Weinberger, Adina Halpern, Zamir Zelber-Sagi, Shira Elinav, Eran Segal, Eran |
author_sort | Rein, Michal |
collection | PubMed |
description | BACKGROUND: Dietary modifications are crucial for managing newly diagnosed type 2 diabetes mellitus (T2DM) and preventing its health complications, but many patients fail to achieve clinical goals with diet alone. We sought to evaluate the clinical effects of a personalized postprandial-targeting (PPT) diet on glycemic control and metabolic health in individuals with newly diagnosed T2DM as compared to the commonly recommended Mediterranean-style (MED) diet. METHODS: We enrolled 23 adults with newly diagnosed T2DM (aged 53.5 ± 8.9 years, 48% males) for a randomized crossover trial of two 2-week-long dietary interventions. Participants were blinded to their assignment to one of the two sequence groups: either PPT-MED or MED-PPT diets. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses (PPGR). We further evaluated the long-term effects of PPT diet on glycemic control and metabolic health by an additional 6-month PPT intervention (n = 16). Participants were connected to continuous glucose monitoring (CGM) throughout the study and self-recorded dietary intake using a smartphone application. RESULTS: In the crossover intervention, the PPT diet lead to significant lower levels of CGM-based measures as compared to the MED diet, including average PPGR (mean difference between diets, − 19.8 ± 16.3 mg/dl × h, p < 0.001), mean glucose (mean difference between diets, − 7.8 ± 5.5 mg/dl, p < 0.001), and daily time of glucose levels > 140 mg/dl (mean difference between diets, − 2.42 ± 1.7 h/day, p < 0.001). Blood fructosamine also decreased significantly more during PPT compared to MED intervention (mean change difference between diets, − 16.4 ± 37 μmol/dl, p < 0.0001). At the end of 6 months, the PPT intervention leads to significant improvements in multiple metabolic health parameters, among them HbA1c (mean ± SD, − 0.39 ± 0.48%, p < 0.001), fasting glucose (− 16.4 ± 24.2 mg/dl, p = 0.02) and triglycerides (− 49 ± 46 mg/dl, p < 0.001). Importantly, 61% of the participants exhibited diabetes remission, as measured by HbA1c < 6.5%. Finally, some clinical improvements were significantly associated with gut microbiome changes per person. CONCLUSION: In this crossover trial in subjects with newly diagnosed T2DM, a PPT diet improved CGM-based glycemic measures significantly more than a Mediterranean-style MED diet. Additional 6-month PPT intervention further improved glycemic control and metabolic health parameters, supporting the clinical efficacy of this approach. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT01892956 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02254-y. |
format | Online Article Text |
id | pubmed-8826661 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88266612022-02-10 Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial Rein, Michal Ben-Yacov, Orly Godneva, Anastasia Shilo, Smadar Zmora, Niv Kolobkov, Dmitry Cohen-Dolev, Noa Wolf, Bat-Chen Kosower, Noa Lotan-Pompan, Maya Weinberger, Adina Halpern, Zamir Zelber-Sagi, Shira Elinav, Eran Segal, Eran BMC Med Research Article BACKGROUND: Dietary modifications are crucial for managing newly diagnosed type 2 diabetes mellitus (T2DM) and preventing its health complications, but many patients fail to achieve clinical goals with diet alone. We sought to evaluate the clinical effects of a personalized postprandial-targeting (PPT) diet on glycemic control and metabolic health in individuals with newly diagnosed T2DM as compared to the commonly recommended Mediterranean-style (MED) diet. METHODS: We enrolled 23 adults with newly diagnosed T2DM (aged 53.5 ± 8.9 years, 48% males) for a randomized crossover trial of two 2-week-long dietary interventions. Participants were blinded to their assignment to one of the two sequence groups: either PPT-MED or MED-PPT diets. The PPT diet relies on a machine learning algorithm that integrates clinical and microbiome features to predict personal postprandial glucose responses (PPGR). We further evaluated the long-term effects of PPT diet on glycemic control and metabolic health by an additional 6-month PPT intervention (n = 16). Participants were connected to continuous glucose monitoring (CGM) throughout the study and self-recorded dietary intake using a smartphone application. RESULTS: In the crossover intervention, the PPT diet lead to significant lower levels of CGM-based measures as compared to the MED diet, including average PPGR (mean difference between diets, − 19.8 ± 16.3 mg/dl × h, p < 0.001), mean glucose (mean difference between diets, − 7.8 ± 5.5 mg/dl, p < 0.001), and daily time of glucose levels > 140 mg/dl (mean difference between diets, − 2.42 ± 1.7 h/day, p < 0.001). Blood fructosamine also decreased significantly more during PPT compared to MED intervention (mean change difference between diets, − 16.4 ± 37 μmol/dl, p < 0.0001). At the end of 6 months, the PPT intervention leads to significant improvements in multiple metabolic health parameters, among them HbA1c (mean ± SD, − 0.39 ± 0.48%, p < 0.001), fasting glucose (− 16.4 ± 24.2 mg/dl, p = 0.02) and triglycerides (− 49 ± 46 mg/dl, p < 0.001). Importantly, 61% of the participants exhibited diabetes remission, as measured by HbA1c < 6.5%. Finally, some clinical improvements were significantly associated with gut microbiome changes per person. CONCLUSION: In this crossover trial in subjects with newly diagnosed T2DM, a PPT diet improved CGM-based glycemic measures significantly more than a Mediterranean-style MED diet. Additional 6-month PPT intervention further improved glycemic control and metabolic health parameters, supporting the clinical efficacy of this approach. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT01892956 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-022-02254-y. BioMed Central 2022-02-09 /pmc/articles/PMC8826661/ /pubmed/35135549 http://dx.doi.org/10.1186/s12916-022-02254-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Rein, Michal Ben-Yacov, Orly Godneva, Anastasia Shilo, Smadar Zmora, Niv Kolobkov, Dmitry Cohen-Dolev, Noa Wolf, Bat-Chen Kosower, Noa Lotan-Pompan, Maya Weinberger, Adina Halpern, Zamir Zelber-Sagi, Shira Elinav, Eran Segal, Eran Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial |
title | Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial |
title_full | Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial |
title_fullStr | Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial |
title_full_unstemmed | Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial |
title_short | Effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed T2DM: a randomized dietary intervention pilot trial |
title_sort | effects of personalized diets by prediction of glycemic responses on glycemic control and metabolic health in newly diagnosed t2dm: a randomized dietary intervention pilot trial |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826661/ https://www.ncbi.nlm.nih.gov/pubmed/35135549 http://dx.doi.org/10.1186/s12916-022-02254-y |
work_keys_str_mv | AT reinmichal effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT benyacovorly effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT godnevaanastasia effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT shilosmadar effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT zmoraniv effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT kolobkovdmitry effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT cohendolevnoa effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT wolfbatchen effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT kosowernoa effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT lotanpompanmaya effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT weinbergeradina effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT halpernzamir effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT zelbersagishira effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT elinaveran effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial AT segaleran effectsofpersonalizeddietsbypredictionofglycemicresponsesonglycemiccontrolandmetabolichealthinnewlydiagnosedt2dmarandomizeddietaryinterventionpilottrial |