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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...

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Autores principales: 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
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
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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.
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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
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