Research Paper Title

Weight Loss, Glycaemic Control, and Cardiovascular Disease Risk Factors in Response to Differential Diet Composition in a Weight Loss Programme in Type 2 Diabetes: A Randomised Controlled Trial.

Objective

To test whether a weight loss programme promotes greater weight loss, glycaemic control, and improved cardiovascular disease risk factors compared with control conditions and whether there is a differential response to higher versus lower carbohydrate intake.

Methods

This randomised controlled trial at two university medical centres enrolled 227 overweight or obese adults with type 2 diabetes and assigned them to parallel in-person diet and exercise counseling, with prepackaged foods in a planned menu during the initial phase, or to usual care (UC; two weight loss counseling sessions and monthly contacts).

Results

Relative weight loss was:

• 7.4% (95% CI, 5.7–9.2%) for lower fat group
• 9.0% (7.1–10.9%) for lower carbohydrate group and
• 2.5% (1.3–3.8%) UC group.

(P < 0.001 intervention effect) Glycaemic control markers and triglyceride levels were lower in the intervention groups compared with UC group at 1 year (fasting glucose 141 [95% CI, 133–149] vs. 159 [144–174] mg/dL, P = 0.010; haemoglobin A_1c 6.9% [6.6–7.1%] vs. 7.5% [7.1–7.9%] or 52 [49–54] vs. 58 [54–63] mmol/mol, P = 0.001; triglycerides 148 [134–163] vs. 204 [173–234] mg/dL, P< 0.001).

The lower versus higher carbohydrate groups maintained lower hemoglobin A_1c (6.6% [95% CI, 6.3–6.8%] vs. 7.2% [6.8–7.5%] or 49 [45–51] vs. 55 [51–58] mmol/mol) at 1 year (P = 0.008).

Conclusions

The weight loss programme resulted in greater weight loss and improved glycaemic control in type 2 diabetes.

Reference

Rock, C.L., Flatt, S.W., Pakiz, B., Taylor, K.S., Leone, A.F., Brelje, K., Heath, D.D., Quintana, E.L. & Sherwood, N.E. (2014) Weight Loss, Glycemic Control, and Cardiovascular Disease Risk Factors in Response to Differential Diet Composition in a Weight Loss Program in Type 2 Diabetes: A Randomized Controlled Trial. Diabetes Care. Published online before print: April 23, 2014, doi:10.2337/dc13-2900.