Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment–Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial.

Description

This randomized controlled trial was conducted to study the effect of intensive dietary intervention on glycemic control and cardiovascular risk factors in patients with type 2 diabetes who had persistent hyperglycemia despite optimized drug treatment. The study sample included a total of 93 patients under 70 years of age with type 2 diabetes and a glycated hemoglobin (HbA1c) of more than 7% and at least two of the following characteristics: overweight or obesity, hypertension and dyslipidemia. Results of this study showed that intensive nutrition treatment was associated with an improvement in glycemic control as well as in the anthropometric measures in patients with type 2 diabetes. The proportion of decline in HbA1c (0.4%) was the same as that observed in clinical trials with the addition of a new drug. As for the nutritional aspects, a decrease in saturated fat and an increase in protein were observed in the intervention group. Thus, these findings suggest that intensive dietary recommendations are important to improve glycemic control and anthropometric variables in patients with type 2 diabetes but they require close professional supervision in order to induce substantial changes. In his editorial comment, Clifton P described the small amount of literature on long-term dietary interventions in patients with type 2 diabetes. He underlined the fact that this study did not allow to conclude which component of the intervention was most effective. Finally, he commented about the necessity of finding interventions that can be delivered without professionnal assistance for long-time periods.