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

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
DOI: 10.2196/44295 Publication Date: 2023-05-11T13:45:35Z
ABSTRACT
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
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