Psychological Support Strategies for Adults With Type 2 Diabetes in a Very Low–Carbohydrate Web-Based Program: Randomized Controlled Trial

• DOI: 10.2196/44295
• Publication Date: 2023-05-11T13:45:35Z
• Authors: Laura R Saslow; Amanda L Missel; Alison O’Brien; Sarah Kim; Frederick M Hecht; Judith T Moskowitz; Hovig Bayandorian; Martha Pietrucha; Kate Raymond; Blair Richards; Bradley Liestenfeltz; Ashley E Mason; Jennifer Daubenmier; James E Aikens
• Keywords: Clinical Sciences; Clinical Trials and Supportive Activities; text messages; 610; Clinical sciences; Diseases of the endocrine glands. Clinical endocrinology; Clinical Research; very low–carbohydrate diet; 616; Behavioral and Social Science; T2D; Obesity; Metabolic and endocrine; Nutrition; Original Paper; Nutrition and Dietetics; Biomedical and Clinical Sciences; Prevention; Diabetes; self-monitoring; 16. Peace & justice; RC648-665; 3. Good health; Good Health and Well Being; glycemic control; eHealth; type 2 diabetes; weight loss

Background A very low–carbohydrate (VLC) nutritional strategy may improve glycemic control and weight loss in adults with type 2 diabetes (T2D). However, the supplementary behavioral strategies that might be able to outcomes using this are uncertain. Objective This study aims compare impact of adding 3 different a web-based VLC diet intervention. To our knowledge, is first trial randomize participants frequencies dietary self-monitoring. Methods The included 112 overweight T2D (hemoglobin A1c ≥6.5%) taking no antiglycemic medications or only metformin. They received remotely delivered 12-month Participants were randomly assigned through full factorial 2×2×2 design strategies: either daily monthly self-monitoring, mindful eating training not, positive affect skills not. Our research goal was determine whether supplemental had at least medium effect size (Cohen d=0.5). Results Overall, intervention led statistically significant improvements (−0.70%, 95% CI −1.04% −0.35%; P<.001), (−6.82%, −8.57% −5.08%; depressive symptom severity d −0.67, −0.92 −0.41; P<.001). Furthermore, 30% (25/83) metformin baseline reduced discontinued their Only 1 Cohen point estimate reached 0.5; (vs monthly) self-monitoring worse on symptoms d=0.47, −0.02 0.95; P=.06). None outcomes. For changes primary outcome, hemoglobin A1c, 0.42% (95% −0.28% 1.12%); for eating, it −0.47% −1.15% 0.22%); affect, 0.12% −0.57% 0.82%). Other results mixed, suggesting an increase (0.98%) d=0.47), less satisfaction d=−0.20), more sessions viewed (3.02), greater adherence d=0.24). suggested benefit d=0.24) d=0.30). d=−0.32), number (3.68), d=0.16), d=0.25). Conclusions support use T2D. addition (not daily) did not show definitive benefit, but worth further testing. Trial Registration ClinicalTrials.gov NCT03037528; https://clinicaltrials.gov/ct2/show/NCT03037528