The health effects of medical nutrition therapy by dietitians in patients with diabetes: A systematic review and meta-analysis

Razaz, Jalaledin Mirzay; Rahmani, Jamal; Varkaneh, Hamed Kord; Thompson, Jacqueline; Clark, Cain C. T.; Abdulazeem, Hebatullah Mohamed

doi:10.1016/j.pcd.2019.05.001

Cited by 36 publications

(29 citation statements)

References 33 publications

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“…Nutrition and exercise and lifestyle modifications are among the key approaches for the management and prevention of diabetes (Balk et al, ; Hordern et al, ; Razaz et al, ) that are considered to be more cost‐effective than medication (Center for Disease Control and Prevention, ). Specifically, the consumption of dietary fiber has been shown to reduce the risk associated with T2DM and cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Xiao

Chen

Deng³

et al. 2020

Phytotherapy Research

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Water-soluble dietary fibers have been shown to improve lipid profile and glucose metabolism in diabetes. The aim of this study was to review the effects of psyllium consumption on weight, body mass index, lipid profiles, and glucose metabolism in diabetic patients in randomized controlled trials. A comprehensive systematic search was performed in PubMed/MEDLINE, Web of Sciences, Cochrane, and Scopus by two independent researchers up to August 2019 without any time and language restrictions. The DerSimonian and Laird random-effects model method performed to calculate the pooled results. Inclusion criteria were randomized controlled trial design, adult subjects, and studies reporting the mean differences with the 95% confidence interval for outcome. Eight studies containing nine arms with 395 participants were identified and included in final analysis. Combined results found a significant reduction in triglycerides, low-density lipoprotein, fasting blood sugar, and hemoglobin A1c Abbreviations: BMI, body mass index; HDL, high-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; TG/TAG, triglycerides.Hui Chen is the co-first author.

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Section: Introductionmentioning

confidence: 99%

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Xiao

Chen

Deng³

et al. 2020

Phytotherapy Research

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“…In parallel with the 4.3% weight loss achieved by the intervention group at 6 months, which meets the minimal 3% recommended for insulin resistance improvements, 8,9 we found improvements in HbA 1c and FBG of similar magnitude to those achieved through face-to-face lifestyle interventions. 5,39,41,42 Importantly, the present intervention produced a more pronounced HbA 1c improvement among those with suboptimal glycemic control, an effect greater than that achieved with most oral glucose-lowering agents. 43 This would have translated to significant long-term protection against microvascular and macrovascular complications, 44,45 suggesting that greater effort should be put in place to optimize lifestyle rather than adding on medications.…”

Section: Discussionmentioning

confidence: 78%

“…Weight loss from the app intervention in this study was similar to that achieved with previous face-to-face lifestyle interventions in individuals with diabetes, despite reduced face-to-face interactions. 5 , 37 , 39 Typically, lifestyle intervention studies involve 3 to 12 visits in the initial 3 to 6 months, with a total duration of 2 to 16 hours. 5 , 40 Because the ease of communication in the app interface allows an increased frequency of touch points between health care professionals and users to facilitate the provision of timely advice at the point of decision-making, it is able to mitigate the potential effects of reduced face-to-face interactions, leading to comparable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Effect of a Smartphone App on Weight Change and Metabolic Outcomes in Asian Adults With Type 2 Diabetes

et al. 2021

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IMPORTANCE Lifestyle interventions are effective in diabetes management, with smartphone apps that manage health data and dietary and exercise schedules gaining popularity. However, limited evidence from randomized clinical trials exists regarding the effectiveness of smartphone-based interventions among Asian adults with type 2 diabetes. OBJECTIVE To compare the effects of a culturally contextualized smartphone-based intervention with usual care on weight and metabolic outcomes. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial conducted at multiple primary care centers in Singapore included 305 adults with type 2 diabetes and body mass index (BMI) of 23 or greater who had literacy in English and smartphone access. Participants were recruited between October 3, 2017, and September 9, 2019, and were randomly assigned (1:1; stratified by gender, age, and BMI) to intervention (99 participants) or control (105 participants) groups. Participants' data were analyzed using intention-to-treat analysis. INTERVENTIONS Both control and intervention participants received diet and physical activity advice from a dietitian at a baseline face-to-face visit. Intervention participants additionally used a smartphone app to track weight, diet, physical activity, and blood glucose and then communicated with dietitians for 6 months. MAIN OUTCOMES AND MEASURES Primary outcome was change in body weight, while secondary outcomes were changes in hemoglobin A 1c (HbA 1c ), fasting blood glucose, blood pressure, lipids, and diet. Post hoc analyses included glycemic changes in the subgroup with HbA 1c levels of 8% or greater and diabetes medication changes. RESULTS Among the 204 randomized participants (mean [SD] age, 51.2 [9.7] years; 132 [64.7%] men), baseline mean (SD) BMI was 30.6 (4.3). Compared with the control group, intervention participants achieved significantly greater reductions in weight (mean [SD] change, −3.6 [4.7] kg vs −1.2 [3.6] kg) and HbA 1c levels (mean [SD] change, −0.7% [1.2] vs −0.3% [1.0]), with a greater proportion having a reduction in diabetes medications (17 participants [23.3%] vs 4 participants [5.4%]) at 6 months. The intervention led to a greater HbA 1c reduction among participants withHbA 1c levels of 8% or higher (mean [SD] change, −1.8% [1.4] vs −1.0% [1.4]; P = .001). Intergroup differences favoring the intervention were also noted for fasting blood glucose, diastolic blood pressure, and dietary changes. (continued) Key Points Question What is the effect of a culturally contextualized smartphonebased lifestyle intervention on weight change and metabolic outcomes in Asian adults who have overweight or obesity and type 2 diabetes compared with usual care? Findings In this randomized clinical trial of 204 adults with type 2 diabetes, the use of a smartphone app tracking personal health data and using integrated behavioral modification strategies led to significantly greater reductions in weight and hemoglobin A 1c , along with a significantly greater proportion of patients with a reduction i...

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“…Healthy eating patterns are reported to improve overall health, achieve and maintain body weight, glycaemic, blood pressure and lipid goals and delay or prevent complications of diabetes [42]. Research has shown that MNT is effective for the treatment of T2DM [43]. MNT delivered by registered dietician is associated with HbA1c decreases of 0.3–2.0% for patients with T2DM [44].…”

Section: Management Of Hyperglycaemia In Diabetesmentioning

confidence: 99%

Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020

Alawadi

Abusnana

Afandi

et al. 2020

Dubai Diabetes Endocrinol J

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Rapid urbanisation and socioeconomic development in the United Arab Emirates (UAE) have led to the widespread adoption of a sedentary lifestyle and Westernised diet in the local population and consequently a high prevalence of obesity and diabetes. In 2019, International Diabetes Federation statistics reported a diabetes prevalence rate of 16.3% for the adult population in the UAE. In view of the wealth of recent literature on diabetes care and new pharmacotherapeutics, the Emirates Diabetes Society convened a panel of experts to update existing local guidelines with international management recommendations. The goal is to improve the standard of care for people with diabetes through increased awareness of these management practices among healthcare providers licensed by national health authorities. These consensus guidelines address the screening, diagnosis and management of type 2 diabetes mellitus in adults including individuals at risk of developing the disease.

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The health effects of medical nutrition therapy by dietitians in patients with diabetes: A systematic review and meta-analysis

Cited by 36 publications

References 33 publications

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose‐response meta‐analysis of randomized controlled trials

Effect of a Smartphone App on Weight Change and Metabolic Outcomes in Asian Adults With Type 2 Diabetes

Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020

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