We found that recommendations to follow a very low-carbohydrate ketogenic diet and to change lifestyle factors helped overweight people with type 2 diabetes or prediabetes improve glycemic control and lose weight
2017
An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial
Key concepts
- metformin
- prediabetes
- United States
- weight loss
- type 2 diabetes mellitus
- diet
- body weight
- chronic disease
- affect regulation
- National Center for Complementary and Integrative Health
- physical activity
- diabetes
- ketogenic
- glycemic control
- Eating disorder
- Center for Epidemiologic Studies Depression Scale
- positive affect
- National Institutes of Health
- eHealth
- social support
Scholarcy highlights
- Type 2 diabetes mellitus is a rapidly growing chronic disease that affects approximately 22 million people in the United States, for which diet is an integral aspect of treatment
- The online delivery of these very low-carbohydrate ketogenic diet and lifestyle recommendations may allow them to have a wider reach in the successful self-management of type 2 diabetes
- We found that recommendations to follow a very low-carbohydrate diet and to make lifestyle changes were able to improve glycemic control and reduce body weight in overweight individuals with type 2 diabetes or prediabetes
- We suggested that participants in the intervention group follow lifestyle recommendations, including behavioral adherence strategies aimed at increasing positive affect regulation and mindful eating based largely on the Mindfulness-Based Eating Awareness Training program, using handouts and lesson content adapted from our in-person intervention
- Our results show that participants randomly assigned to the very low-carbohydrate ketogenic diet and lifestyle recommendations group had a variety of health benefits including lower HbA1c, body weight, and triglyceride levels, compared to those assigned to the control group
- At 32 weeks, participants in the intervention group reduced their HbA1c levels more than participants in the control group
- Future work should examine how robust these results are with larger, more diverse participants; determine whether more robust psychological or other intervention support could improve dietary adherence; track whether the positive health effects are sustained over time; and, through more thorough implementation research, whether and how such an online intervention can dovetail with existing in-person health care teams
- The online delivery of this approach gives it the potential to have wider impact in the treatment of type 2 diabetes
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