A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial
Abstract Background/objectives In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2023-08-01
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| Series: | Nutrition & Diabetes |
| Online Access: | https://doi.org/10.1038/s41387-023-00240-8 |
| _version_ | 1797555579995029504 |
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| author | Jedha Dening Mohammadreza Mohebbi Gavin Abbott Elena S. George Kylie Ball Sheikh Mohammed Shariful Islam |
| author_facet | Jedha Dening Mohammadreza Mohebbi Gavin Abbott Elena S. George Kylie Ball Sheikh Mohammed Shariful Islam |
| author_sort | Jedha Dening |
| collection | DOAJ |
| description | Abstract Background/objectives In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges of accessibility and availability of dietary education and support for T2DM. No previous study had evaluated a web-based LCD intervention using a randomised controlled trial (RCT) design. The objective of this study was to assess whether a web-based LCD programme provided in conjunction with standard care improves glycaemic control in adults with T2DM. Subjects/methods A 16-week parallel RCT was conducted remotely during Covid-19 among the general community, recruiting adults with T2DM not on insulin aged 40–89 years. Participants were randomly assigned (1:1) to standard care plus the web-based T2Diet healthy LCD education programme (intervention) or standard care only (control). The primary outcome was haemoglobin A1c (HbA1c). Secondary outcomes were weight, body mass index (BMI), anti-glycaemic medication, dietary intake, and self-efficacy. Blinded data analysis was conducted by intention-to-treat. Results Ninety-eight participants were enrolled, assigning 49 to each group, with 87 participants (n = 40 intervention; n = 47 control) included in outcome analysis. At 16 weeks, there was a statistically significant between-group difference favouring the intervention group, with reductions in HbA1c –0.65% (95% CI: –0.99 to –0.30; p < 0.0001), weight –3.26 kg (p < 0.0001), BMI –1.11 kg/m2 (p < 0.0001), and anti-glycaemic medication requirements –0.40 (p < 0.0001), with large effect sizes Cohen’s d > 0.8. Conclusion This study demonstrated that as an adjunct to standard care, the web-based T2Diet programme significantly improved glycaemic control and clinical outcomes in adults with T2DM. In addition, the results highlight the potential to improve access and availability for people with T2DM to achieve glycaemic control and improved health through web-based dietary education and support. |
| first_indexed | 2024-03-10T16:49:29Z |
| format | Article |
| id | doaj.art-1f1611e5092c4ecc9e8324dcf434fb3b |
| institution | Directory Open Access Journal |
| issn | 2044-4052 |
| language | English |
| last_indexed | 2024-03-10T16:49:29Z |
| publishDate | 2023-08-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Nutrition & Diabetes |
| spelling | doaj.art-1f1611e5092c4ecc9e8324dcf434fb3b2023-11-20T11:21:32ZengNature Publishing GroupNutrition & Diabetes2044-40522023-08-011311810.1038/s41387-023-00240-8A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trialJedha Dening0Mohammadreza Mohebbi1Gavin Abbott2Elena S. George3Kylie Ball4Sheikh Mohammed Shariful Islam5Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin UniversityBiostatistics Unit, Faculty of Health, Deakin UniversityInstitute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin UniversityInstitute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin UniversityInstitute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin UniversityInstitute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin UniversityAbstract Background/objectives In people with type 2 diabetes mellitus (T2DM), low carbohydrate diets (LCD), defined as 10–<26% total energy intake from carbohydrate, have indicated improved glycaemic control and clinical outcomes. Web-based interventions can help overcome significant challenges of accessibility and availability of dietary education and support for T2DM. No previous study had evaluated a web-based LCD intervention using a randomised controlled trial (RCT) design. The objective of this study was to assess whether a web-based LCD programme provided in conjunction with standard care improves glycaemic control in adults with T2DM. Subjects/methods A 16-week parallel RCT was conducted remotely during Covid-19 among the general community, recruiting adults with T2DM not on insulin aged 40–89 years. Participants were randomly assigned (1:1) to standard care plus the web-based T2Diet healthy LCD education programme (intervention) or standard care only (control). The primary outcome was haemoglobin A1c (HbA1c). Secondary outcomes were weight, body mass index (BMI), anti-glycaemic medication, dietary intake, and self-efficacy. Blinded data analysis was conducted by intention-to-treat. Results Ninety-eight participants were enrolled, assigning 49 to each group, with 87 participants (n = 40 intervention; n = 47 control) included in outcome analysis. At 16 weeks, there was a statistically significant between-group difference favouring the intervention group, with reductions in HbA1c –0.65% (95% CI: –0.99 to –0.30; p < 0.0001), weight –3.26 kg (p < 0.0001), BMI –1.11 kg/m2 (p < 0.0001), and anti-glycaemic medication requirements –0.40 (p < 0.0001), with large effect sizes Cohen’s d > 0.8. Conclusion This study demonstrated that as an adjunct to standard care, the web-based T2Diet programme significantly improved glycaemic control and clinical outcomes in adults with T2DM. In addition, the results highlight the potential to improve access and availability for people with T2DM to achieve glycaemic control and improved health through web-based dietary education and support.https://doi.org/10.1038/s41387-023-00240-8 |
| spellingShingle | Jedha Dening Mohammadreza Mohebbi Gavin Abbott Elena S. George Kylie Ball Sheikh Mohammed Shariful Islam A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial Nutrition & Diabetes |
| title | A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial |
| title_full | A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial |
| title_fullStr | A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial |
| title_full_unstemmed | A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial |
| title_short | A web-based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes: results of the T2Diet Study randomised controlled trial |
| title_sort | web based low carbohydrate diet intervention significantly improves glycaemic control in adults with type 2 diabetes results of the t2diet study randomised controlled trial |
| url | https://doi.org/10.1038/s41387-023-00240-8 |
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