Dietary advice for treatment of type 2 diabetes mellitus in adults

Moore, Helen; Summerbell, Carolyn; Hooper, Lee; Cruickshank, Kennedy; Vyas, Avni; Johnstone, Paul; Ashton, V; Kopelman, P

doi:10.1002/14651858.cd004097.pub4

Cited by 103 publications

(73 citation statements)

References 290 publications

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“…Strengths of our study relative to past trials include longer study duration, the use of an intention-to-treat model and the measurement of dietary compliance. Attrition rates typically range from 30% to 50% in weight loss trials [21] and in dietary studies in type 2 diabetes [22]. This study followed up 94% of all participants who received dietary advice and relied on the last measurement carried forward for the small number of individuals who discontinued the study.…”

Section: Discussionmentioning

confidence: 99%

The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial

et al. 2011

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Aims/hypothesis Short-term dietary studies suggest that high-protein diets can enhance weight loss and improve glycaemic control in people with type 2 diabetes. However, the long-term effects of such diets are unknown. The aim of this study was to determine whether high-protein diets are superior to high-carbohydrate diets for improving glycaemic control in individuals with type 2 diabetes. Methods Overweight/obese individuals (BMI 27-40 kg/m 2 ) with type 2 diabetes (HbA 1c 6.5-10%) were recruited for a 12 month, parallel design, dietary intervention trial conducted at a diabetes specialist clinic (Melbourne, VIC, Australia). Of the 108 initially randomised, 99 received advice to follow low-fat (30% total energy) diets that were either high in protein (30% total energy, n=53) or high in carbohydrate (55% total energy, n=46). Dietary assignment was done by a third party using computer-generated random numbers. The primary endpoint was change in HbA 1c . Secondary endpoints included changes in weight, lipids, blood pressure, renal function and calcium loss. Study endpoints were assessed blinded to the diet group, but the statistical analysis was performed unblinded. This study used an intention-to-treat model for all participants who received dietary advice. Follow-up visits were encouraged regardless of dietary adherence and last measurements were carried forward for study non-completers. Results Ninety-nine individuals were included in the analysis (53 in high protein group, 46 in high carbohydrate group). HbA 1c decreased in both groups over time, with no significant difference between groups (mean difference of the change at 12 months; 0.04 [95% CI −0.37, 0.46]; p=0.44). Both groups also demonstrated decreases over time in weight, serum triacylglycerol and total cholesterol, and increases in HDL-cholesterol. No differences in blood pressure, renal function or calcium loss were seen. Conclusions/interpretation These results suggest that there is no superior long-term metabolic benefit of a high-protein diet over a high-carbohydrate in the management of type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial

et al. 2011

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“…Randomized controlled trials have demonstrated beneficial effects of lifestyle interventions on glycemic control (10)(11)(12). Recent studies provide strong evidence that lifestyle counseling in routine care settings is associated with improved glycemic control, confirming the findings of clinical trials (13).…”

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confidence: 67%

Electronic Documentation of Lifestyle Counseling and Glycemic Control in Patients With Diabetes

et al. 2015

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OBJECTIVETo establish quantitative characteristics of lifestyle counseling documentation associated with improved glycemic control in patients with diabetes. RESEARCH DESIGN AND METHODSWe retrospectively studied 10,870 hyperglycemic (HbA 1c ‡7.0% [53 mmol/mol]) adults with diabetes followed at primary care practices affiliated with two academic hospitals between 2000 and 2010. Documentation intensity was represented by the mean number of characters per note documenting lifestyle counseling. Heterogeneity was calculated as the normalized Levenshtein distance between lifestyle counseling sentences between consecutive notes. Cox proportional hazards model was constructed to assess association of heterogeneity and intensity of lifestyle counseling documentation to time to HbA 1c <7.0% (53 mmol/mol) while adjusting for demographics, initial HbA 1c level, insulin therapy, medication intensification, and frequency of lifestyle counseling. RESULTSComparing patients in the highest versus lowest tertile by documentation heterogeneity and documentation intensity, median time to HbA 1c <7.0% (53 mmol/mol) was 26 vs. 39 months and 24 vs. 39 months, respectively (P < 0.001 for all). In multivariable analysis, an increase of documentation heterogeneity by 0.15 units and an increase of documentation intensity by 45 characters/note was associated with hazard ratios of 1.08 (95% CI 1.04-1.12; P < 0.001) and 1.27 (95% CI 1.23-1.31; P < 0.001) for time to HbA 1c target, respectively. CONCLUSIONSHigher heterogeneity and intensity of lifestyle counseling documentation in provider notes were associated with better glycemic control. Further studies involving direct observation of patient care are needed to establish the nature of the relationship between documentation characteristics and patient outcomes.The prevalence of diabetes is rapidly increasing in the U.S. and worldwide (1-3). Chronic hyperglycemia is associated with increased risk of microvascular and macrovascular complications, and maintaining glycemic levels as close to nondiabetic range as possible can substantially reduce the risk (4-6). Nevertheless, a large number of patients with diabetes do not reach target glycemic levels recommended by treatment guidelines (7-9).

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“…Meta analysis [24] of effects of different modes of exercise training on glucose control done by Snowling and Hopkins, concluded that aerobic, resistance and combined exercise have small to moderate beneficial effect on glucose control in type 2 diabetic patients. Study [25] done by Nield et al to assess the effects of different types of dietary advice through weight change in people with type 2 diabetes, and the effects of dietary advice plus other lifestyle interventions (i.e. exercise, behavioural approaches) through weight change in people, appears to improve glycated haemoglobin at six and twelve months in people with type 2 d iabetes.…”

Section: Discussionmentioning

confidence: 99%

Health Intervention Impact Assessment on Glycemic Status of Diabetic patients

Mahajan¹,

Kambali²,

Chokhandre³

et al. 2013

DIABETES

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Diabetes has been proved to be the leading cause of mo rbidity and mortality in developed countries, and is gradually emerg ing as an important health problem in developing countries as well. Diabetes, an iceberg disease could be described as the 'sleeping snake'-which bites when it wakes up. Diabetics, who are joyfully mov ing in and around us in the society, who are really not aware of the possible catastrophic end results of harbouring this 'sleeping snake'. This study was carried out to assess the impact of health intervention on life style, self care pract ices and Glycemic status of Diabetic patients. A cross-sectional study was conducted at Shivaji Nagar urban slu m which is a field practice area of Depart ment of Preventive and Social Medicine; of TN Medical Co llege Mu mbai, Ind ia. Diabetic patients above 40 years of age were included in this study. The informat ion was gathered by personal interview using semi-structured questionnaire. The collected data was numerically coded and entered in Microsoft Excel 2007 and then transferred to SPSS version 15.0 Added data was analysed with appropriate test and results were obtained. Out of 300 subjects183 (61%) were males, 146 (48.7%) patients were in the age group of 51-60. Before intervention 178 (59.3%) patients' had Body mass index (BMI) > 25 kg/ m 2 and they had poor control over blood sugar. Significant improvement in life style, self care practices; illness perception and Glycemic status of patients were seen after health intervention. People have to be educated through mass media about Diabetes and its risk factors like consumption of food having high Glycemic index, alcohol etc. People have to be educated on the importance of regular physical exercises and should be encouraged to do the same.

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Dietary advice for treatment of type 2 diabetes mellitus in adults

Cited by 103 publications

References 290 publications

The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial

The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: a 12 month randomised controlled trial

Electronic Documentation of Lifestyle Counseling and Glycemic Control in Patients With Diabetes

Health Intervention Impact Assessment on Glycemic Status of Diabetic patients

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