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20-07-2010 | Diabetes | Article

LOADD results show benefits of intensive dietary advice for glycemic control

Abstract

Free abstract

MedWire News: Study results show that intensive dietary advice can significantly improve glycemic control, aid weight loss, and decrease waist circumference in individuals with Type 2 diabetes.

The Lifestyle Over and Above Drugs in Diabetes (LOADD) study was set up by Kirsten Coppell and fellow researchers from the University of Otago in Dunedin, New Zealand, to assess whether an intensive dietary intervention could improve glycemic control and cardiovascular risk factors in 94 Type 2 diabetes patients with a glycated hemoglobin (HbA1c) level above 7% despite pharmacological treatment.

Of the participants, 46 were assigned to usual diabetes care plus dietary intervention and 48 to usual care alone. The dietary intervention consisted of intensive individualized dietary advice for 6 months, twice in the first month and then monthly thereafter. The advice followed recommendations set by the European Association for the Study of Diabetes.

At 6 months, participants given the dietary intervention had a 0.4% greater reduction in HbA1c than those in the usual care group, a statistically significant difference.

In addition, reductions in weight, body mass index, and waist circumference were all significantly greater in the intervention than the control group, with between group differences of 1.3 kg, 0.5, and 1.6 cm, respectively.

Of note, improvements in blood pressure and lipid levels were not significantly greater in the intervention than the control group.

Regarding nutritional intake, the most prominent difference between the two groups was a 1.9% decrease in the intake of saturated fat and a 1.6% increase in protein intake in the intervention compared with the control group.

"Individualized intensive dietary advice has the potential to improve glycemic control and anthropometric measures in patients with Type 2 diabetes and unsatisfactory HbA1c despite optimized hypoglycemic drug treatment," conclude the researchers.

They add: "This requires not only expert advice but also support from the family and an environment that enables appropriate food choices."

The results of this study are published in the British Medical Journal.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert