Diabetic Educational Eating Plan (DEEP)
Applicability of a Low Glycemic Index Diet in Diabetes
By improving glycemic control, many of the devastating complications of diabetes are to a large extent preventable. The use of a low GI (glycemic index) diet to improve glycemic control is relatively new and untested. However, a low GI diet may be a cost-effective approach to preventing diabetes-related complications. The aim of this proposed 2-year study is to gather pilot data on the feasibility of implementing a nutritionist-delivered low GI intervention, to reduce dietary GI in patients with type 2 diabetes, and to compare it with a nutritionist-delivered standard American Diabetes Association (ADA) diet intervention. Our outcomes are recruitment and retention rates, as well as physiological measures (HbA1c, blood lipids, blood pressure, and body mass index), dietary GI scores and acceptability of the intervention.
Primary hypotheses:
1. Recruitment and retention rates for the low GI intervention will be satisfactory.
Secondary hypotheses:
- Participants in the low GI intervention group will show more favorable changes in physiological measures than participants in the ADA diet group.
- Participants in the low GI group will be successful in lowering the GI of their diet.
- Participants will find the intervention acceptable.
調査の概要
詳細な説明
The glycemic index (GI) is a ranking of carbohydrate containing foods according to the rate at which they raise blood glucose levels after eating. A recent meta-analysis of randomized clinical trials (RCT) suggests that choosing low GI foods has a small but clinically useful effect on medium-term glycemic control in patients with type 2 diabetes. However, in most of the reviewed RCTs, patients were fed experimental diets and therefore there is still controversy over the applicability of GI in the clinical setting for management of diabetes. In addition, there is no evidence that long-term consumption of a low GI diet will contribute to improved glycemic control in people with diabetes.
Our ultimate goal for a future larger RCT is to evaluate the long-term effects of using low GI diet in type 2 diabetics. The primary outcome variable of the future large trial will be glycosylated hemoglobin levels (HbA1c), a measure reflecting average glycemic level during the preceding 2-3 months. The proposed feasibility study will recruit 40 patients with type 2 diabetes and will randomly assign them to one of two groups: a low GI nutrition education group (low GI group) and a standard ADA dietary education group as the control group (ADA group) (20 patients in each group).
For both groups, the intervention phase will last 6 months and consist of an initial group session, an individual session, and then four group counseling sessions. The follow-up phase will be six months and consist of two group booster sessions, one at 8-months and another at 10-months. The low GI nutritional education will be primarily targeted at a low GI diet. The focus is not on decreasing total carbohydrate intake, but rather encouraging patients to substitute low GI foods for high GI foods. The dietary intervention will be based on a patient-centered counseling model which has been demonstrated to facilitate health behavior change. Data collection points coincide with two phases of the intervention. Assessments, including demographics, anthropometric measurements, diet and physical activity recalls, and clinical data, will be conducted at baseline, and at 6 and 12 months after randomization, with blood samples collected at each interval. We will track response to recruitment, adherence, and retention. Quantitative and qualitative methods will be used to assess acceptability of the intervention.
The aim of this proposed 2-year study is to gather pilot data on the feasibility of implementing a nutritionist-delivered low GI intervention to reduce dietary GI in patients with type 2 diabetes. Our outcomes are recruitment and retention rates, as well as physiological measures (HbA1c, blood pressure, and body mass index), dietary GI scores and acceptability of the intervention.
By improving glycemic control, many of the devastating complications of diabetes are to a large extent preventable. The use of a low GI diet to improve glycemic control is relatively new and untested. However, a low GI diet may be a cost-effective approach to preventing diabetes-related complications. Testing the feasibility of such a program and its potential impact would be an important step towards an RO1 application to the NIH.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
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Massachusetts
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Worcester、Massachusetts、アメリカ、01655
- University of Massachusetts Medical School
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Diagnosis of type II diabetes in the medical chart
- HbA1c level >= 7 (an indication of poor control of diabetes)
- Currently being treated with diet, oral hypoglycemic agents and/or insulin
- At least 21 years old
- Telephone in home or easy access to one
- Able to understand study protocol
- Understands and can provide informed consent
- Physician's approval to participate in study
- Has a blood glucose machine or a prescription for one from their physician
- Able to speak and read English
- Willing to be randomized to either of the two study groups
- Able to participate in the study for a one year length of time.
Exclusion Criteria:
- Pregnant or planning to become pregnant during the study
- Unable or unwilling to provide informed consent
- Plans to move out of the area within the 12-month study period
- Required intermittent glucocorticoid therapy within the past 3 months
- Documented acute coronary event (MI or unstable angina) within the past 6 months
- Diagnosis of a medical condition that precludes adherence to study dietary recommendations (e.g. Crohn's disease, ulcerative colitis, end-stage renal disease)
- Diagnosis of a psychiatric illness (i.e. dementia, psychiatric hospitalization or suicidality within the past 5 years). We will not exclude individuals with a diagnosis of depression or patients taking anti-depressants.
- Following a low-carbohydrate high fat dietary regimen such as the Atkins diet, or currently following the South Beach Diet
- Legally blind or has significant visual impairments
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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アクティブコンパレータ:ADA diet
Patients will be encouarged to consume foods consisted with ADA dietary recommendation
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ADA dietary education
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実験的:Low-GI
a low GI dietary education
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low-GI education
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
---|---|
Our outcomes are recruitment and retention rates, as well as physiological measures (HbA1c, blood pressure, and body mass index), dietary GI scores and acceptability of the intervention
時間枠:one year
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one year
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協力者と研究者
捜査官
- 主任研究者:Yunsheng Ma, MD, Ph.D.、Division of Preventive & Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School
出版物と役立つリンク
一般刊行物
- Ma Y, Olendzki BC, Hafner AR, Chiriboga DE, Culver AL, Andersen VA, Merriam PA, Pagoto SL. Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus. Nutrition. 2006 Nov-Dec;22(11-12):1129-36. doi: 10.1016/j.nut.2006.08.006. Epub 2006 Oct 4.
- Ma Y, Olendzki BC, Merriam PA, Chiriboga DE, Culver AL, Li W, Hebert JR, Ockene IS, Griffith JA, Pagoto SL. A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with type 2 diabetes. Nutrition. 2008 Jan;24(1):45-56. doi: 10.1016/j.nut.2007.10.008.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
ADA dietの臨床試験
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Mondelēz International, Inc.KGK Science Inc.完了
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Ada Health GmbHMuhimbili University of Health and Allied Sciences積極的、募集していない神経学的状態 | メンタルヘルスの状態 | 腹痛/胃腸の問題 | 下部呼吸器系の状態 | 上部呼吸器系の状態 | 眼科の症状 | 整形外科的症状 | 心血管系の状態 | 泌尿生殖器系の状態 | 耳鼻咽喉科の症状 | 皮膚科の症状 | 婦人科/産科の病気タンザニア
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Physicians Committee for Responsible MedicineGeorge Washington University一時停止