Dataset Information

Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit.

ABSTRACT:

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Background

Reduction of dietary carbohydrates and corresponding insulin doses stabilizes and lowers mean blood glucose in individuals with type 1 diabetes within days. The long-term adherence for persons who have learned this technique is unknown. To assess adherence over 4?years in such a group the present audit was done retrospectively by record analysis for individuals who have attended an educational course. Adherence was assessed from HbA1c changes and individuals' own reports.

Findings

Altogether 48 persons with diabetes duration of 24?±?12?years and HbA1c?>?= 6.1% (Mono-S; DCCT?=?7.1%) attended the course. Mean HbA1c for all attendees was at start, at 3?months and 4?years 7.6%?±?1.0%, 6.3?±?0.7%, 6.9?±?1.0% respectively. The number of non-adherent persons was 25 (52%). HbA1c in this group was at start, at 3?months and 4?years: 7.5 ±1.1%, 6.5?±?0.8%, 7.4?±?0.9%. In the group of 23 (48%) adherent persons mean HbA1c was at start, at 3?months and 4?years 7.7?±?1.0%, 6.4?±?0.9%, 6.4?±?0.8%.

Conclusion

Attending an educational course on dietary carbohydrate reduction and corresponding insulin reduction in type 1 diabetes gave lasting improvement. About half of the individuals adhered to the program after 4?years. The method may be useful in informed and motivated persons with type 1 diabetes. The number needed to treat to have lasting effect in 1 was 2.

SUBMITTER: Nielsen JV

PROVIDER: S-EPMC3583262 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Publications

Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit.

Nielsen Jørgen Vesti JV Gando Caroline C Joensson Eva E Paulsson Carina C

Diabetology & metabolic syndrome 20120531 1

<h4>Unlabelled</h4><h4>Background</h4>Reduction of dietary carbohydrates and corresponding insulin doses stabilizes and lowers mean blood glucose in individuals with type 1 diabetes within days. The long-term adherence for persons who have learned this technique is unknown. To assess adherence over 4 years in such a group the present audit was done retrospectively by record analysis for individuals who have attended an educational course. Adherence was assessed from HbA1c changes and individuals ...[more]

PMID: 22650646

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Project description:BackgroundType 2 diabetes mellitus (T2DM) is a leading cause of morbidity and mortality globally, with adverse health consequences largely related to hyperglycemia. Despite clinical practice guideline recommendations, effective pharmacotherapy, and interventions to support patients and providers, up to 60% of patients diagnosed with T2DM are estimated to have hemoglobin A1c (HbA1c) levels above the recommended targets owing to multilevel barriers hindering optimal glycemic control.ObjectiveThe aim of this study is to compare changes in HbA1c levels among patients with suboptimally controlled T2DM who were offered the opportunity to use an intermittently viewed continuous glucose monitor and receive personalized low-carbohydrate nutrition counseling (<100 g/day) versus those who received usual care (UC).MethodsThis was a 12-month, pragmatic, randomized quality improvement program. All adult patients with T2DM who received primary care at a university-affiliated primary care clinic (N=1584) were randomized to either the UC or the enhanced care (EC) group. Within each program arm, we identified individuals with HbA1c >7.5% (58 mmol/mol) who were medically eligible for tighter glycemic control, and we defined these subgroups as UC-high risk (UC-HR) or EC-HR. UC-HR participants (n=197) received routine primary care. EC-HR participants (n=185) were invited to use an intermittently viewed continuous glucose monitor and receive low-carbohydrate nutrition counseling. The primary outcome was mean change in HbA1c levels from baseline to 12 months using an intention-to-treat difference-in-differences analysis comparing EC-HR with UC-HR groups. We conducted follow-up semistructured interviews to understand EC-HR participant experiences with the intervention.ResultsHbA1c decreased by 0.41% (4.5 mmol/mol; P=.04) more from baseline to 12 months among participants in the EC-HR group than among those in UC-HR; however, only 61 (32.9%) of 185 EC-HR participants engaged in the program. Among the EC-HR participants who wore continuous glucose monitors (61/185, 32.9%), HbA1c was 1.1% lower at 12 months compared with baseline (P<.001). Interviews revealed themes related to EC-HR participants' program engagement and continuous glucose monitor use.ConclusionsAmong patients with suboptimally controlled T2DM, a combined approach that includes continuous glucose monitoring and low-carbohydrate nutrition counseling can improve glycemic control compared with the standard of care.

Dataset Information

Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit.

Unlabelled

Background

Findings

Conclusion

Publications

Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit.

Similar Datasets

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