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Effects of Basic Carbohydrate Counting Versus Standard Outpatient Nutritional Education in Type 2 Diabetes

Not Applicable
Completed
Conditions
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Type2 Diabetes
Interventions
Behavioral: Standard nutritional education
Behavioral: Basic carbohydrate counting
Registration Number
NCT03623139
Lead Sponsor
Steno Diabetes Center Copenhagen
Brief Summary

The aim of the study is to examine the health benefits of adding a concept in basic carbohydrate counting (BCC) to the routine outpatient nutritional education for adult patients with type 2 diabetes.

The study hypothesis is that training and education in the BCC concept will improve glycaemic control either by reducing HbA1c or the average plasma glucose variability more than offering the routine dietary care as a stand-alone dietary treatment.

Detailed Description

The trial has a parallel-group design with a study duration of 48 weeks for each participant (a 6-month intervention period and a 6-month follow-up period). A total of 226 patients will be enrolled in the trial. Participants will be randomized to one of two arms: 1) Standard medical and dietary care (control group) or 2) Structured training and education in the BCC concept in addition to standard medical and dietary care.

The primary objective is to evaluate the six months effect of structured training and education in the BCC concept compared to standard dietary care on glycaemic control as assessed by HbA1c or MAGE (mean amplitude of glycaemic excursions).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  • Type 2 diabetes
  • Diabetes duration; from >12 months
  • HbA1c between 53 and 97 mmol/mol
  • Diet or any glucose-lowering medication
  • Provided voluntary written informed consent
Exclusion Criteria
  • Practicing carbohydrate counting, as judged by the investigator
  • Participated in a BCC group program within the last two years
  • Low daily intake of carbohydrates (defined as below 25 E% or 100 g/day), as judged by the investigator
  • Use of open CGM
  • Use of a Free Libre device
  • Use of an automated bolus calculator for carbohydrate counting, as judged by the investigator
  • Gastroparesis
  • Pregnancy or breastfeeding, or plans of pregnancy within the study period
  • Uncontrolled medical issues, as judged by the investigator
  • Concomitant participation in other clinical studies
  • Unable to understand the informed consent and the study procedures

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard nutritional educationStandard nutritional educationControl group
BCCBasic carbohydrate countingEducation and training i basic carbohydrate counting (BCC) plus standard nutritional education
Primary Outcome Measures
NameTimeMethod
Change in mean amplitude of glycaemic excursions (MAGE)Baseline, 6 months

mmol/l

Change in HbA1cBaseline, 6 months

mmol/mol

Secondary Outcome Measures
NameTimeMethod
Change in mathematical literacyBaseline, 6 months, 12 months

total score or percent (%)

Change in intake of dietary fibreBaseline, 6 months

gram/day or g/MJ

Change in body weightBaseline, 6 months, 12 months

kg

Change in low-density lipoprotein cholesterol (LDL-C)Baseline, 6 months, 12 months

mmol/l

Change in total cholesterol (TC)Baseline, 6 months, 12 months

mmol/l

Change in diastolic blood pressureBaseline, 6 months, 12 months

mm Hg

Change in systolic blood pressureBaseline, 6 months, 12 months

mm Hg

Change in waist circumferenceBaseline, 6 months, 12 months

cm

Change in HbA1c12 months

mmol/mol

Changes in time spent in hypoglycaemia (<3.9 mmol/l)Baseline, 6 months

percent (%)

Change in dietary intake of carbohydratesBaseline, 6 months

gram/day or percent of total energy (E%)

Change in dietary intake of monounsaturated fatty acids (MUFA)Baseline, 6 months

gram/day or percent of total energy (E%)

Change in dietary intake of polyunsaturated fatty acids (PUFA)Baseline, 6 months

gram/day or percent of total energy (E%)

Change in triglycerides (TG)Baseline, 6 months, 12 months

mmol/l

Change in standard deviation of mean plasma glucoseBaseline, 6 months

mmol/l

Change in carbohydrate estimation accuracyBaseline, 6 months, 12 months

total score or %

Change in degree of autonomy-supportive dietitianBaseline, 6 months, 12 months

total score or percent (%)

Change in total energy intakeBaseline, 6 months

kJ/day

Change in high-density cholesterol (HDL-C)Baseline, 6 months, 12 months

mmol/l

Change in free fatty acids (FFA)Baseline, 6 months, 12 months

mmol/l

Change in hip circumferenceBaseline, 6 months, 12 months

cm

Change in total fat massBaseline, 6 months

gram

Change in time in range (3.9-10.0 mmol/l)Baseline, 6 months

percent (%)

Change time spent in hyperglycaemia (e.g. >11.1 mmol/l)Baseline, 6 months

percent (%)

Change in perceived competences in diabetesBaseline, 6 months, 12 months

total score or percent (%)

Change in dietary intake of saturated fatty acids (SFA)Baseline, 6 months

gram/day or percent of total energy (E%)

Change in total fat free massBaseline, 6 months

gram

Change in diet-related quality of lifeBaseline, 6 months, 12 months

total score or percent (%)

Change in dietary intake of total fatBaseline, 6 months

gram/day or percent of total energy (E%)

Change in dietary intake of proteinBaseline, 6 months

gram/day or percent of total energy (E%)

Change in dietary intake of added sugarBaseline, 6 months

gram/day , % of total energy or %

Trial Locations

Locations (1)

Steno Diabetes Center Copenhagen

🇩🇰

Herlev, Denmark

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