scholarly journals 3461 A community-based, low calorie dietary intervention for the prevention and remission of type 2 diabetes mellitus

2019 ◽  
Vol 3 (s1) ◽  
pp. 137-137
Author(s):  
Kim Qumby ◽  
Colette George ◽  
Ian Hambleton ◽  
Patrick Olivier ◽  
Nigel Unwin
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Dietary Intervention ◽  
Fasting Blood Glucose ◽  
Community Setting ◽  
Diabetes Remission ◽  
Dietary Advice ◽  
Low Calorie ◽  
Health Team ◽  
Physical Measurements

OBJECTIVES/SPECIFIC AIMS: The aim is to investigate if sustained weight loss due to caloric restriction can be achieved in a community setting, using faith-based organisations (FBOs) as hubs; and if this weight loss can lead to the re-establishment of normal metabolism (using the normalisation of blood sugar levels while off glucose lowering medication as a proxy) in a person with pre-diabetes or T2DM. METHODS/STUDY POPULATION: Members of the FBO with either a diagnosis of T2DM for <6 years or pre-diabetes as defined by the American Diabetes Association (ADA); and a Body Mass index (BMI) of ≥27 kg/m2 are eligible. After counselling, participants will be placed on a 12 week low calorie liquid diet, supplemented by low carbohydrate vegetables, totalling approximately 840 kcal/day. During this time, participants will be monitored weekly at their FBO by trained members of their congregation, with oversight from the study team, for change in weight, fasting blood glucose, waist and hip circumference and blood pressure. This will be followed by a 3 month period during which participants will receive ongoing dietary advice as they transfer to a balanced, reduced calorie, solid diet. Physical measurements will be monitored monthly during this 3 month period. The next 6 months is a period where the participants and the FBO health team move towards ‘independence’. This involves further training of the FBO health team and participants in healthy lifestyle habits; and a commitment by the leadership of the FBO to assume ‘ownership’ for NCD monitoring within their community. Physical measurements will be repeated at the end of one year. RESULTS/ANTICIPATED RESULTS: Based on previous studies, we expect that participants who are compliant to the diet will lose approximately 2.2 kg per week over the 12 week period. This will be associated with rapid (within 1 week) normalisation of fasting blood glucose levels (<7mmol / L). We expect that, due to the accessibility of NCD monitoring and support, that participants to be satisfied with their care and compliant to their regime and that the results of the first 12 weeks will be sustained at the 12 month follow up. We expect that the FBO leadership will assume the responsibility of continuing and NCD programme, not only for the local congregation but for the surrounding community. DISCUSSION/SIGNIFICANCE OF IMPACT: Diabetes remission with a low calorie diet is a viable intervention for T2DM remission however social support is key to an individual’s success. This novel study which proposes institution of a diabetes remission intervention which fits into the participant’s locale and involves peer support, should increase long-term success.

scholarly journals Implementation of a community-based low-calorie dietary intervention for the induction of type-2 diabetes and pre-diabetes remission: a feasibility study utilising a type 2 hybrid design

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Kim R. Quimby ◽  
Natasha Sobers ◽  
Colette George ◽  
Natalie Greaves ◽  
Francine Browman-Jones ◽  
...  
Keyword(s):  
Weight Loss ◽  
Feasibility Study ◽  
Clinical Skills ◽  
Fasting Blood Glucose ◽  
Diabetes Remission ◽  
Community Based ◽  
Implementation Phase ◽  
Implementation Effectiveness ◽  
Low Calorie

Abstract Objectives The aims of this feasibility study were to (1) examine the implementation of a community-based health advocate (CHA) training programme to develop the clinical skills needed to support a diabetes remission protocol based on a low-calorie diet (LCD) and (2) investigate if participant weight loss can be achieved and diabetes remission induced under these conditions. Methods This tripartite study followed a type 2 implementation-effectiveness design. Three faith-based organisations (FBOs) were purposively selected as study sites. Implementation outcomes were guided by the Consolidated Framework for Implementation Research. During the pre-implementation phase, site ‘readiness’ to facilitate the intervention was determined from a site visit and an interview with the FBOs’ leadership. During the implementation phase, congregants could volunteer for the 10-week CHA training which included practical exercises in weight, glucose and blood pressure (BP) measurement, and a summative practical assessment. Acceptability and implementation effectiveness were assessed via survey. During the intervention phase, other congregants and community members with T2DM or pre-diabetes and overweight were invited to participate in the 12-week LCD. Anti-diabetic medication was discontinued on day 1 of the intervention. Clinical effectiveness was determined from the change in weight, fasting blood glucose (FBG) and BP which were monitored weekly at the FBO by the CHA. HbA1C was performed at weeks 1 and 12. Results The FBOs were found to be ready as determined by their adequate resources and engagement in health-related matters. Twenty-nine CHAs completed the training; all attained a passing grade at ≥1 clinical station, indicating implementation effectiveness. CHA feedback indicated that the programme structure was acceptable and provided sufficient access to intervention-related material. Thirty-one persons participated in the LCD (11 T2DM:20 pre-diabetes). Mean (95%CI) weight loss was 6.0 kg (3.7 to 8.2), 7.9 kg in males vs 5.7 kg in females; A1C (%) decreased from 6.6 to 6.1, with a greater reduction in those with T2DM when compared to pre-diabetes. FBG decreased from 6.4 to 6.0mmol/L. T2DM remission rates were 60% and 90% by A1C<6.5% and FBG<7mmol/L respectively. Pre-diabetes remission was 18% and 40% by A1C<5.7% and FBG<5.6 respectively. Conclusion Implementation of a community-based diabetes remission protocol is both feasible and clinically effective. Its sustainability is to be determined. Adaptability to other disorders or other settings should be investigated. Trial registration NCT03536377 registered on 24 May 2018.

scholarly journals Effect of time restricted eating on body weight and fasting glucose in participants with obesity: results of a randomized, controlled, virtual clinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pamela M. Peeke ◽  
Frank L. Greenway ◽  
Sonja K. Billes ◽  
Dachuan Zhang ◽  
Ken Fujioka
Keyword(s):  
Clinical Trial ◽  
Weight Loss ◽  
Body Weight ◽  
Blood Glucose ◽  
Dietary Intervention ◽  
Fasting Blood Glucose ◽  
Exercise Program ◽  
Management Program ◽  
Controlled Clinical Trial ◽  
Randomized Controlled

Abstract Background Time restricted eating (TRE) is an emerging dietary intervention for weight loss that is hypothesized to reinforce the metabolic benefits of nightly fasting/ketosis. This pilot study investigated the effectiveness of a daily 14-h metabolic fast (14:10 TRE beginning after dinner, a “fasting snack” at hour 12, and ending with breakfast 14 h later) combined with a commercial weight management program on body weight and fasting blood glucose (FBG) in individuals with obesity. We also investigated the effect of the low-calorie, high-fat, low-carbohydrate, and low-protein “fasting snack” on blood glucose. Methods This 8-week, randomized, controlled, clinical trial included men and women (BMI ≥ 30 kg/m2) between June and October 2020. Study procedures were conducted remotely. Participants were randomized to 14:10 or 12-h TRE (12:12, active comparator) and prescribed a diet (controlled for calories and macronutrient composition) and exercise program that included weekly customized counseling and support. The primary outcome was change from baseline in body weight in the 14:10 group. Results Of the 78 randomized participants, 60 (n = 30/group) completed 8 weeks. The LS mean change from baseline in weight in the 14:10 group was −8.5% (95% CI −9.6 to −7.4; P < 0.001) and −7.1% (−8.3 to −5.8; P < 0.001) in the 12:12 group (between group difference −1.4%; −2.7 to −0.2; P < 0.05). There was a statistically significant LS mean change from baseline to week 8 in FBG in the 14:10 group of −7.6 mg/dl (95% CI −15.1 to −0.1; P < 0.05) but not in the 12:12 group (−3.1 mg/dl, −10.0 to 3.7; P = NS). Both interventions resulted in a larger reduction in FBG in participants with elevated FBG (≥100 mg/dl) at baseline (both P < 0.05). Conclusions In participants with obesity who completed 8 weeks of the 14:10 TRE schedule combined with a commercial weight loss program, there was statistically significant and clinically meaningful weight loss and improvements in FBG.

scholarly journals Implementation of a Community-Based Low-Calorie Dietary Intervention for the Induction of Type-2 Diabetes and Pre-Diabetes Remission: A Feasibility Study Utilising a Type-2 Hybrid Design

2021 ◽  
Author(s):  
Kim Quimby ◽  
Natasha Sobers ◽  
Colette George ◽  
Natalie Greaves ◽  
Francine Browman-Jones ◽  
...  
Keyword(s):  
Weight Loss ◽  
Feasibility Study ◽  
Clinical Skills ◽  
Fasting Blood Glucose ◽  
Diabetes Remission ◽  
Community Based ◽  
Implementation Phase ◽  
Implementation Effectiveness ◽  
Low Calorie

Abstract Objectives The aims of this feasibility study were to (1) examine the implementation of a community-based health advocate (CHA) training program to develop the clinical skills needed to support a diabetes remission protocol based on a low-calorie diet (LCD) and (2) investigate if participant weight loss can be achieved and diabetes remission induced under these conditions. Methods This tripartite study followed a type-2 implementation-effectiveness design. Three faith-based organizations (FBOs) were purposively selected as study sites. Implementation outcomes were guided by the Consolidated Framework for Implementation Research. During the pre-implementation phase, site ‘readiness’ to facilitate the intervention was determined from a site visit and an interview with the FBOs’ leadership. During the implementation phase, congregants could volunteer for the 10-week CHA training which included practical exercises in weight, glucose and blood pressure (BP) measurement, and a summative practical assessment. Acceptability and implementation effectiveness were assessed via survey. During the intervention phase, other congregants and community members with T2DM or pre-diabetes and overweight were invited to participate in the 12-week LCD. Anti-diabetic medication was discontinued on day-1 of the intervention. Clinical effectiveness was determined from the change in weight, fasting blood glucose (FBG) and BP which were monitored weekly at the FBO by the CHA. HbA1C was performed at week 1 and 12. Results The FBOs were found to be ready as determined by their adequate resources and engagement in health-related matters. Twenty-nine CHAs completed the training; all attained a passing grade at ≥ 1 clinical station, indicating implementation effectiveness. CHA feedback indicated that the program structure was acceptable and provided sufficient access to intervention-related material. Thirty-one persons participated in the LCD (11 T2DM:20 pre-diabetes). Mean (95%CI) weight loss was 6.8kgs (5.4–8.2) p < 0.00001; 7.9kgs in males vs 6.6kgs in females; A1C decreased from 6.6–6.2%, p = 0.003 and FBG from 6.4-6.0mmol/L; p = 0.004. T2DM remission rates were 60% and 90% by A1C < 6.5% and FBG < 7mmol/L respectively. Pre-diabetes remission was 18% and 40% by A1C < 5.7% and FBG < 5.6 respectively. Conclusion Implementation of a community-based diabetes remission protocol is both feasible and clinically effective. Its sustainability is to be determined. Adaptability to other disorders or other settings should be investigated. Trial Registration : NCT03536377 registered 24th May 2018 at https://clinicaltrials.gov/ct2/show/NCT03536377

scholarly journals Association of a Self-Paid Medically Supervised Weight Management Program with Reversal of Obesity-Associated Impaired Fasting Glucose

2021 ◽  
Vol 11 (2) ◽  
pp. 386-394
Author(s):  
Vijaya Surampudi ◽  
Xinkai Zhou ◽  
Chi-Hong Tseng ◽  
David Heber ◽  
Zhaoping Li
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Retrospective Analysis ◽  
Weight Management ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Management Program ◽  
Weight Management Program ◽  
Glucose Levels

Aims: The progression of prediabetes to T2DM can be delayed through diet modification and weight management. However, the intensive lifestyle program is often not covered by medical insurance. This retrospective analysis evaluates the association of a patient self-paid weight management program on an improvement of blood sugar in overweight and obese patients with impaired fasting glucose (IFG). Methods: The medical records of 4634 patients who participated in the self-pay UCLA Weight Management Program were reviewed and 2572 patients met the criteria for this retrospective analysis to examine whether this program was associated with the reversal of IFG over 3 months among 1396 patients with normal fasting glucose (NFG) and 1176 with IFG. Results: The patients with IFG lost comparable amounts of weight (10.5 ± 1.3 kg) at three months, as did the subjects with NFG (10.1 ± 1.3 kg). Fasting blood glucose in the IFG group decreased from 108.49 ± 6.4 to 101.8 ± 9.41 mg/dL (p < 0.0001) after three months. There were also significant reductions in triglycerides, and both systolic and diastolic blood pressure in both groups in association with weight loss. Conclusion: Our medically supervised self-pay multidisciplinary weight management program was associated with reduced fasting blood glucose levels in patients with IFG over three months with comparable weight loss to patients with NFG.

scholarly journals The consumption of low-calorie sweetener containing foods during pregnancy: results from the ROLO study

2021 ◽  
Author(s):  
Marie C. Conway ◽  
Shona Cawley ◽  
Aisling A. Geraghty ◽  
Niamh M. Walsh ◽  
Eileen C. O’Brien ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Dietary Intervention ◽  
Intervention Group ◽  
Glycaemic Index ◽  
Dietary Advice ◽  
Control Group ◽  
Food Groups ◽  
Food Diary ◽  
Low Calorie ◽  
Child Health Outcomes

Abstract Background/objectives Women with gestational diabetes (GDM) are advised to adapt a low glycaemic index (GI) diet, which may impact consumption of low-calorie sweeteners (LCS). LCS are increasingly popular as they add sweetness without contributing calories. This study aims to investigate the reported intakes of LCS-containing foods in women during pregnancy. Subjects/methods Pregnant women recruited for the ROLO study were included in this analysis (n = 571). Women were randomised to receive either an intervention of low-GI dietary advice or usual antenatal care. Women completed a 3-day food diary in each trimester. Nine LCS-containing food groups were identified, and the quantity (g/day) consumed was calculated. Results One-third of all pregnant women consumed LCS across each trimester of pregnancy. Of those in the intervention group who were LCS consumers in trimester 1, 71.6% were consumers in trimester 2, and 54.1% remained consumers in trimester 3. In the control group, less women remained consumers in trimester 2 and 3 at 58.1% and 41.9%, respectively. In trimester 2, following the dietary intervention, the proportion of LCS consumers in the intervention group was significantly higher than the proportion of consumers who were in the control group (p < 0.001). The most commonly consumed food groups were low-calorie fruit drinks, diet-cola drinks, and low-calorie yoghurts. Conclusions One-third of pregnant women consumed LCS. The proportion of LCS consumers increased in the intervention group compared to the control group. Further research is needed to determine exposure levels to individual LCS, and the effect of prenatal exposure to LCS on maternal and child health outcomes.

Eating to stop diabetes

2020 ◽  
Vol 12 (549) ◽  
pp. eabc8952
Author(s):  
Priyathama Vellanki
Keyword(s):  
Weight Loss ◽  
Diabetes Remission ◽  
Significant Weight Loss ◽  
Low Calorie ◽  
Very Low Calorie Diets

Very low-calorie diets can induce and sustain significant weight loss and diabetes remission.

Abstract 2368: Baseline Dietary Glycemic Load as a Predictor of Weight Loss on the Atkins, Zone, Weight Watchers and Ornish Diets.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Aaron F Buchsbaum ◽  
Ernst J Schaefer ◽  
Michael L Dansinger
Keyword(s):  
Weight Loss ◽  
Dietary Intervention ◽  
Linear Trend ◽  
Glycemic Load ◽  
Dietary Advice ◽  
Dietary Adherence ◽  
Dietary Glycemic Load ◽  
One Year ◽  
Intent To Treat ◽  
Weight Watchers

Background: Methods for matching patients with optimal diets are lacking. We previously reported that 4 popular diets (Atkins, Zone, Weight Watchers and Ornish), which range from low to high in dietary carbohydrate and glycemic load, produced similar 1-year weight loss in a randomized trial. We tested the hypothesis that dietary glycemic load at baseline (prior to dietary intervention) would affect the magnitude of weight loss from each diet. Methods: We randomized 160 overweight and obese adults (mean BMI=35) to follow the Atkins, Zone, Weight Watchers, or Ornish dietary advice. Participants attempted maximum dietary adherence and attended 4 small-group classes during the first 2 months, then self-selected dietary adherence levels for the following 10 months. One-year weight loss for each diet was determined according to tertiles of baseline dietary glycemic load, assessed by 3-day food records, nutrition analysis software, and published glycemic index tables. Missing data were replaced with baseline values in an intent-to-treat analysis (n=40 per diet). Results: The association between 1-year weight loss and dietary glycemic load at baseline differed significantly according to diet type (p<.01 for interaction). Participants in the highest tertile of dietary glycemic load at baseline had greater weight loss on lower carbohydrate diets (−4.6 kg, −4.6 kg, −2.1 kg, −1.5 kg for Atkins, Zone, Weight Watchers, and Ornish, respectively; p=0.05 for linear trend), and participants in the lowest tertile of dietary glycemic load at baseline had greater weight loss on higher carbohydrate diets (+0.3 kg, −1.0 kg, −3.2 kg, −5.3 kg for Atkins, Zone, Weight Watchers, and Ornish, respectively; p=0.01 for linear trend). For the middle tertile of baseline dietary glycemic load, weight loss did not differ between diets (−1.7 kg, −4.1 kg, −3.8 kg, −1.5 kg for Atkins, Zone, Weight Watchers, and Ornish, respectively, p=0.6 for linear trend, p=0.3 for two highest vs. two lowest). Conclusions: Dietary glycemic load intake prior to dietary intervention may impact the effectiveness of popular diets for weight loss, and may be an important consideration in optimal diet selection for individual patients. These results should be verified in other study populations.

scholarly journals Improvement of insulin resistance after diet with a whole-grain based dietary product: results of a randomized, controlled cross-over study in obese subjects with elevated fasting blood glucose

2007 ◽  
Vol 98 (5) ◽  
pp. 929-936 ◽  
Author(s):  
Klaus Rave ◽  
Kerstin Roggen ◽  
Sibylle Dellweg ◽  
Tim Heise ◽  
Heike tom Dieck
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Body Weight ◽  
Blood Glucose ◽  
Dietary Intervention ◽  
Fasting Blood Glucose ◽  
Model Assessment ◽  
Whole Grain ◽  
Resistance Score

Subjects with obesity and elevated fasting blood glucose are at high risk of developing type 2 diabetes which may be reduced by a dietary intervention leading to an improvement of insulin resistance. We investigated the potential of a whole-grain based dietary product (WG) with reduced starch content derived from double-fermented wheat during a hypo-energetic diet to positively influence body weight, fasting blood glucose, insulin resistance and lipids in comparison to a nutrient-dense meal replacement product (MR) in a randomized two-way cross-over study with two 4-week treatment periods separated by a 2-week wash-out. Subjects replaced at least two daily meals with WG and MR, respectively, targeting for a consumption of 200 g of either product per day. Total daily energy intake was limited to 7120 kJ. Thirty-one subjects (BMI 33·9 (sd 2·7) kg/m2, fasting blood glucose 6·3 (sd 0·8) mmol/l) completed the study. In both treatment groups body weight ( − 2·5 (sd 2·0) v. − 3·2 (sd 1·6) kg for WG v. MR), fasting blood glucose ( − 0·4 (sd 0·3) v. − 0·5 (sd 0·5) mmol/l), total cholesterol ( − 0·5 (sd 0·5) v. − 0·6 (sd 0·5) mmol/l), TAG ( − 0·3 (sd 0·9) v. − 0·3 (sd 1·2) mmol/l) and homeostasis model assessment (HOMA) insulin resistance score ( − 0·7 (sd 0·8) v. − 1·1 (sd 1·7) μU/ml ×  mmol/l) improved (P < 0·05) with no significant differences between the treatments. After statistical adjustment for the amount of body weight lost, however, the comparison between both groups revealed that fasting serum insulin (P = 0·031) and HOMA insulin resistance score (P = 0·049) improved better with WG than with MR. We conclude that WG favourably influences metabolic risk factors for type 2 diabetes independent from the amount of body weight lost during a hypo-energetic diet.

Sign in / Sign up

Export Citation Format

Share Document