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Diabetes Care. 2014 Jun;37(6):1573-80. doi: 10.2337/dc13-2900. Epub 2014 Apr 23.

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.

Author information

1
Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA clrock@ucsd.edu.
2
Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA.
3
HealthPartners Research Institute for Education and Research and Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.

Abstract

OBJECTIVE:

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

RESEARCH DESIGN AND METHODS:

This randomized controlled trial at two university medical centers 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%), 9.0% (7.1-10.9%), and 2.5% (1.3-3.8%) for the lower fat, lower carbohydrate, and UC groups (P < 0.001 intervention effect). Glycemic 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 = 0.023; hemoglobin A1c 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 A1c (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 program resulted in greater weight loss and improved glycemic control in type 2 diabetes.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01345500.

PMID:
24760261
PMCID:
PMC4392939
DOI:
10.2337/dc13-2900
[Indexed for MEDLINE]
Free PMC Article
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