Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial

<p><strong>Introduction:</strong> There is strong evidence that type 2 diabetes (T2D) remission can be achieved by adopting a low-energy diet achieved through total dietary replacement products. There is promising evidence that low-carbohydrate diets can achieve remission of T2D. T...

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Main Authors: Scragg, J, Morris, E, Wane, S, Noreik, M, Jerome, D, Yu, L-M, Galal, U, Dyson, P, Tan, GD, Fox, R, Breeze, P, Thomas, C, Jebb, SA, Aveyard, P
Format: Journal article
Language:English
Published: Elsevier 2023
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author Scragg, J
Morris, E
Wane, S
Noreik, M
Jerome, D
Yu, L-M
Galal, U
Dyson, P
Tan, GD
Fox, R
Breeze, P
Thomas, C
Jebb, SA
Aveyard, P
author_facet Scragg, J
Morris, E
Wane, S
Noreik, M
Jerome, D
Yu, L-M
Galal, U
Dyson, P
Tan, GD
Fox, R
Breeze, P
Thomas, C
Jebb, SA
Aveyard, P
author_sort Scragg, J
collection OXFORD
description <p><strong>Introduction:</strong> There is strong evidence that type 2 diabetes (T2D) remission can be achieved by adopting a low-energy diet achieved through total dietary replacement products. There is promising evidence that low-carbohydrate diets can achieve remission of T2D. The Dietary Approaches to the Management of type 2 Diabetes (DIAMOND) programme combines both approaches in a behaviourally informed low-energy, low-carbohydrate diet for people with T2D, delivered by nurses in primary care. This trial compares the effectiveness of the DIAMOND programme to usual care in inducing remission of T2D and in reducing risk of cardiovascular disease.</p> <p><strong>Methods and analysis:</strong> We aim to recruit 508 people in 56 practices with T2D diagnosed within 6 years, who are demographically representative of the UK population. We will allocate general practices, based on ethnicity and socioeconomic status, to provide usual care for diabetes or offer the DIAMOND programme. Participants in practices offering DIAMOND will see the nurse seven times over 6 months. At baseline, 6 months, and 1 year we will measure weight, blood pressure, HbA1c, lipid profile and risk of fatty liver disease. The primary outcome is diabetes remission at 1 year, defined as HbA1c < 48 mmol/mol and off glucose-lowering medication for at least 6 months. Thereafter, we will assess whether people resume treatment for diabetes and the incidence of microvascular and macrovascular disease through the National Diabetes Audit. Data will be analysed using mixed-effects generalised linear models.</p> <p>This study has been approved by the National Health Service Health Research Authority Research Ethics Committee (Ref: 22/EM/0074).</p> <p>Trial Registration number: ISRCTN46961767.</p>
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spelling oxford-uuid:f8d7c262-44c4-4302-bc8b-656eefcf433f2023-11-07T11:40:14ZDietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f8d7c262-44c4-4302-bc8b-656eefcf433fEnglishSymplectic ElementsElsevier2023Scragg, JMorris, EWane, SNoreik, MJerome, DYu, L-MGalal, UDyson, PTan, GDFox, RBreeze, PThomas, CJebb, SAAveyard, P<p><strong>Introduction:</strong> There is strong evidence that type 2 diabetes (T2D) remission can be achieved by adopting a low-energy diet achieved through total dietary replacement products. There is promising evidence that low-carbohydrate diets can achieve remission of T2D. The Dietary Approaches to the Management of type 2 Diabetes (DIAMOND) programme combines both approaches in a behaviourally informed low-energy, low-carbohydrate diet for people with T2D, delivered by nurses in primary care. This trial compares the effectiveness of the DIAMOND programme to usual care in inducing remission of T2D and in reducing risk of cardiovascular disease.</p> <p><strong>Methods and analysis:</strong> We aim to recruit 508 people in 56 practices with T2D diagnosed within 6 years, who are demographically representative of the UK population. We will allocate general practices, based on ethnicity and socioeconomic status, to provide usual care for diabetes or offer the DIAMOND programme. Participants in practices offering DIAMOND will see the nurse seven times over 6 months. At baseline, 6 months, and 1 year we will measure weight, blood pressure, HbA1c, lipid profile and risk of fatty liver disease. The primary outcome is diabetes remission at 1 year, defined as HbA1c < 48 mmol/mol and off glucose-lowering medication for at least 6 months. Thereafter, we will assess whether people resume treatment for diabetes and the incidence of microvascular and macrovascular disease through the National Diabetes Audit. Data will be analysed using mixed-effects generalised linear models.</p> <p>This study has been approved by the National Health Service Health Research Authority Research Ethics Committee (Ref: 22/EM/0074).</p> <p>Trial Registration number: ISRCTN46961767.</p>
spellingShingle Scragg, J
Morris, E
Wane, S
Noreik, M
Jerome, D
Yu, L-M
Galal, U
Dyson, P
Tan, GD
Fox, R
Breeze, P
Thomas, C
Jebb, SA
Aveyard, P
Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial
title Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial
title_full Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial
title_fullStr Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial
title_full_unstemmed Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial
title_short Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial
title_sort dietary approaches to the management of type 2 diabetes diamond in primary care a protocol for a cluster randomised trial
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