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Dietary Intervention to Improve Cardiometabolic Risk Profile in Individuals with Type 2 Diabetes

Not Applicable
Completed
Conditions
Diabetes Mellitus, Type 2
Cardiovascular Diseases
Interventions
Behavioral: Personalized Dietary Advice
Registration Number
NCT05666843
Lead Sponsor
Wageningen University
Brief Summary

This is a randomized controlled trial to examine whether personalized guidance to increase the consumption of fiber rich food items according to the Dutch dietary guidelines, compared to usual care, improves health of individuals with type 2 diabetes.

Detailed Description

Previous interventions with fibre supplements show promising results among individuals with type 2 diabetes, but wether these effects are similar when higher fiber intake is achieved through diet and not through supplements remains unclear.

The primary objective of this study is to investigate the effects of personalized dietary guidance to increase the intake of fibre-rich foods, as recommended in the Dutch dietary guidelines, on cardiometabolic risk profile in individuals who have type 2 diabetes, compared to usual care after six months.

The study is a parallel randomized trial over a period of twelve months, including an intervention period of six months and a follow up period of six months. The study population consists of adults with non-insulin-dependent type 2 diabetes, diagnosed by a medical doctor at least 6 months prior to study enrolment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
124
Inclusion Criteria
  • Diagnosis of type 2 diabetes made by a medical doctor at least 6 months prior to study enrolment
  • Adult
  • Willing and able to follow dietary intervention
  • Willing to participate in both intervention and control group
  • Living at a reasonable distance from the research center at Wageningen University & Research (WUR) (i.e.maximum of ± 1 hour away)
Exclusion Criteria
  • Currently treated with insulin therapy
  • Recently (< 6 months) or currently being under supervision of a dietician
  • Pregnant or breast-feeding
  • History of bariatric surgery, including gastric banding
  • Current participation in a study with an investigational drug or dietary intervention
  • Excessive alcohol consumption (more than 14 units for males/7 units for females per week) or drug use
  • Clinical disorders that could interfere with the intervention (e.g. gastro-intestinal disorders, auto-immune diseases, psychiatric disorders, uncontrolled heart diseases, serious neurological disorders, renal failure or cancer)
  • Not able to speak and understand the Dutch language
  • No general practitioner
  • Working at the department of Human Nutrition and Health at Wageningen University & Research

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention groupPersonalized Dietary AdvicePersonalized dietary guidance to increase the intake of fibre-rich foods on top of usual care. The dietary guidance is implemented by dieticians and is personalized based on current adherence to the dietary guidelines, usual dietary intake, gender and personal goals and preferences.
Primary Outcome Measures
NameTimeMethod
Cardiometabolic risk profile (DIAL risk score)Change from baseline at 6 months

The change in cardiovascular risk based on observed changes in HbA1c, LDL-cholesterol and systolic blood pressure. DIAL risk score ranges from 0 to 100%, with higher scores indicating a higher risk.

Secondary Outcome Measures
NameTimeMethod
Cardiometabolic risk profile (DIAL risk score)Change from baseline at 12 months

The change in cardiovascular risk based on observed changes in HbA1c, LDL-cholesterol and systolic blood pressure. DIAL risk score ranges from 0 to 100%, with higher scores indicating a higher risk.

Liver functionbaseline, 6 months, 12 months

Aspartate transaminase (AST) and Alanine transaminase (ALT) ratio as determined from blood sample

Health index scorebaseline, 3 months, 6 months, 12 months

5-level EuroQol-5D version (EQ-5D). The maximum score of 1 indicates the best health state. In addition, there is a visual analogue scale (VAS) to indicate the general health status with 100 indicating the best health status.

Hand grip strengthbaseline, 6 months, 12 months

Hand grip strength (kg) using a hand-held dynamometer

Skeletal muscle fat infiltrationbaseline, 6 months, 12 months

Echo intensity of the skeletal muscle rectus femoris (ultrasound)

Dietary intakebaseline, 3 months, 6 months, 12 months

Nutrient intake and diet quality score for the level of adherence to the Dutch dietary guidelines. Diet quality score (Dutch Healthy Diet index) ranges from 0-160, with higher scores indicating better diet quality.

Productivitybaseline, 3 months, 6 months, 12 months

Productivity by means of Institute for Medical Technology Assessment (iMTA) Productivity Cost Questionnaire (iPCQ)

Leg muscle strengthbaseline, 6 months, 12 months

Measured as time to perform the 5 times sit-to-stand test (sec)

Balance scorebaseline, 6 months, 12 months

Tandem Romberg test score, range 0-4 with higher scores indicating better balance

Flexibilitybaseline, 6 months, 12 months

Measured as distance between finger and toes when performing the chair sit-and-reach test (cm)

Body weight (in kilograms)baseline, 6 months, 12 months

As measured with a digital scale

Blood pressurebaseline, 6 months, 12 months

Systolic and diastolic blood pressure (mmHg) as determined with a digital blood pressure monitor

Estimated Glomerular Filtration Rate (eGFR)baseline, 6 months, 12 months

in ml/min/1,73 m2 as determined from blood sample

Urinary albumin levelsbaseline, 6 months, 12 months

in grams per deciliter (g/dL) as determined from urine sample

Inflammatory markersbaseline, 6 months, 12 months

hsCRP in blood samples

Self efficacy scorebaseline, 3 months, 6 months, 12 months

Self-efficacy as assessed with the Dutch General Self-Efficacy scale (DGSES). The total score ranges between 10 and 40, with a higher score indicating more self-efficacy.

Body mass index (kg/m^2)baseline, 6 months, 12 months

Weight and height will be combined to report BMI in kg/m\^2.

Blood lipidsbaseline, 6 months, 12 months

Total cholesterol, HDL-cholesterol, LDL-cholesterol, Triglycerides

Micronutrient statusbaseline, 6 months, 12 months

Micronutrient status as measured with biomarkers in blood and (24-hour) urine samples

Food literacybaseline, 3 months, 6 months, 12 months

Food literacy level by means of the 29-item Self Perceived Food Literacy Scale (SPFL-29). Scores range from 29-145, with higher scores indicating a higher level food literacy.

HbA1cbaseline, 6 months, 12 month

As determined in blood samples

Fasting glucosebaseline, 6 months, 12 month

As determined in blood samples

Fasting insulinbaseline, 6 months, 12 month

As determined in blood samples

Sleep quality scorebaseline, 3 months, 6 months, 12 months

Sleep quality by means of Pittsburgh Sleep Quality Index (PSQI). A range of 0-21; higher scores indicate worse sleep quality.

Cardiovascular conditionbaseline, 6 months, 12 months

Heart rate (bpm) 1 minute after 3-minute step test

Waist circumferencebaseline, 6 months, 12 months

in centimeters

C-peptidebaseline, 6 months, 12 month

As determined in blood samples

Quality of life scorebaseline, 3 months, 6 months, 12 months

Health related quality of life assessed with the 36-Item Short Form Survey (SF-36). Scores range from 0-100, with higher scores indicating higher quality of life.

Positive health scorebaseline, 3 months, 6 months, 12 months

Positive health is assessed with the 17-item Positive Health measurement scale. scores range from 0-170 with higher scores indicating higher positive health.

Medical consumptionbaseline, 3 months, 6 months, 12 months

Medical consumption (incl. medication) by means of Institute for Medical Technology Assessment (iMTA) Medical Consumption Questionnaire (iMCQ)

Trial Locations

Locations (1)

Wageningen University and Research

🇳🇱

Wageningen, Gelderland, Netherlands

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