Barriers to adherence to a nutritional plan and strategies to overcome them in patients with type 2 diabetes mellitus; results after two years of follow-up

Landa-Anell, María Victoria; Melgarejo-Hernández, Marco Antonio; García-Ulloa, Ana Cristina; Razo-Olvera, Fabiola Mabel Del; Velázquez-Jurado, Héctor; Hernández-Jiménez, Sergio

doi:10.1016/j.endien.2020.01.004

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…There was no education regarding barriers to diet adherence, counselling on a nutritional plan, nor diet compliance and regulation in the current study -all would allow visualization of the effect of BTI320 in these T2DM patients [53]. Future studies should implement tools (e.g., Continuous Glucose Monitor (CGM), food diaries, mobile tablets/apps which alert the individual on his/her diet) to then be able to focus on the direct effects of interventions [53][54][55][56], although we agree that mobile technology needs further validation [57]. One of the strengths of the current study is the cross-over design, allowing each subject to be his/her own baseline, thus eliminating confounding results due to glucose variability.…”

Section: Discussionmentioning

confidence: 95%

Dose-ranging study of BTI320 in type 2 diabetic patients

Luke¹,

Cheng²,

Lee³

et al. 2020

Trends Diabetes Metab

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Background/objectives: Current practice is to treat diabetics with oral hypoglycemics, insulin, or a combination of both; these systemic interventions are not without risk. The reduction in glucose excursion is a new therapeutic paradigm with non-systemic interventions which has been suggested to delay diabetic-associated complications. BTI320, derived from galactomannan, is a non-systemic drug to attenuate postprandial glucose excursion by blocking carbohydrate hydrolyzing enzymes within the gastrointestinal tract. Earlier studies of BTI320 have shown decreased glucose excursions with relatively few adverse effects.Subjects/methods: This double-blind, placebo-controlled, 3-period crossover, outpatient study evaluated two different doses of BTI320, 4 g and 8 g three times daily before meals, for 7 days in 23 adults with Type 2 diabetes (mean age 54 years, BMI 31.4 kg/m 2 ). The primary endpoint of the response of postprandial glucose excursion was measured by the area under the curve from 0 to 4 hours (PPG-AUC0-4) following a high carbohydrate meal on the final day of dosing in each crossover arm. Results:The mean (± SD) PPG-AUC0-4 after 7 days of dosing placebo, 4 g, and 8 g BTI320 were 179.09 ± 157.271, 146.61 ± 98.604, and 179.09 ± 157.27 mmol/L*min, respectively, in the intent-to-treat population, demonstrating appreciable effects of 4 g BTI-320 compared with placebo. Similar trends were found in the PPG peak glucose levels and time to peak glucose concentrations. Consistent with other studies, the mean glucose serum concentrations at 2 hours following 4 g BTI320 (7.57 ± 1.519 mmol/L) were markedly lower than those following placebo and 8 g BTI320 (7.63 ± 1.826 and 7.68 ± 1.711 mg/dL, respectively). Conclusion:Data from this proof of concept study comparing two doses (4 and 8 g) of BTI320 demonstrated evidence of 4 g BTI320 in reducing glucose excursions compared with the 8 g BTI320 and placebo arms per subject. Whereas these data support other published studies of BTI320 limiting the magnitude of glucose excursion, variables such as rate of glucose absorption, age of the patient, and amount of carbohydrates in each meal, amongst others, require an expanded population in a Phase 3 trial to confirm these findings.

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Section: Discussionmentioning

confidence: 95%

Dose-ranging study of BTI320 in type 2 diabetic patients

Luke¹,

Cheng²,

Lee³

et al. 2020

Trends Diabetes Metab

View full text Add to dashboard Cite

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“…These results support recommending a high omega 3 diet to patients in clinical practice. The major barrier to widespread success of any dietary intervention is adherence because strict diets require time, financial investment, and change in habits 1314. Therefore, it will be crucial for future research to determine how easy or difficult it is for patients to implement diets rich in omega 3 fatty acids at home, with or without lowering intake of omega 6.…”

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confidence: 99%

Dietary omega 3 fatty acids for migraine

Burch

2021

BMJ

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Adherence and Barriers to Medical Nutrition Therapy and the Effect on Glycemic Control Among Individuals With Type 2 Diabetes in India

Deshmane

Muley

2022

Curr Res Nutr Food Sci

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Medical Nutrition Therapy (MNT) has a remarkable effect on glycemic control among individuals with Type 2 Diabetes. However, the extent of adherence to MNT isn't hundred percent. Therefore, we aim to determine the adherence level towards the MNT advised by a Registered Dietitian (RD); to identify the barriers and associated contributing factors and strategies to improve the compliance towards the MNT among people with Type 2 Diabetes. A cross-sectional study was conducted among people with Type 2 Diabetes visiting the out-patient diabetes clinic from Kolhapur city, India. A structured questionnaire was used to capture the adherence and non-adherence, reasons and barriers to adhering the MNT. Out of 293 participants, 41.6% were adhering to the MNT. There was a significant association between the non working group (p = 0.01), presence of co-morbidities (p = 0.03) and diabetes duration < 10 years (p = 0.05) with the increased adherence level. Similarly, there was a significant reduction of 26.7%, 38.1%, and 30.9% in the fasting, postprandial blood glucose and HbA1c values respectively in adhering group post MNT advice. More than 50% of the participants in the adhering group gave ‘To Improve overall health’ and ‘To control sugar’ as reasons to adhere. ‘Habitual to what they eat’ (64.3%), ‘Does not satisfy hunger’ (42.1%) and ‘Lack of willpower’ (42.1%), were the common barriers identified in our study. Our study shows that the MNT advised by an RD is effective in reducing the socio-cultural barriers to adherence and improves glycemic control. Strategies like making the workplace more diabetes-friendly and adopting behavior changing techniques should be implemented to increase adherence.

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Barriers to adherence to a nutritional plan and strategies to overcome them in patients with type 2 diabetes mellitus; results after two years of follow-up

Cited by 3 publications

References 12 publications

Dose-ranging study of BTI320 in type 2 diabetic patients

Dose-ranging study of BTI320 in type 2 diabetic patients

Dietary omega 3 fatty acids for migraine

Adherence and Barriers to Medical Nutrition Therapy and the Effect on Glycemic Control Among Individuals With Type 2 Diabetes in India

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