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The Lifestyle Education About Nutrition for Diabetes (Legend) Study

Not Applicable
Recruiting
Conditions
Type 2 Diabetes
Interventions
Behavioral: Moderate-carbohydrate plate-method diet
Behavioral: Very low-carbohydrate diet
Registration Number
NCT05237128
Lead Sponsor
University of Michigan
Brief Summary

This study is being completed to compare two dietary approaches for participants with type 2 diabetes. This research will test whether a very low-carbohydrate or a plate-method diet better improves outcomes for blood glucose control and body composition for patients with type 2 diabetes that follow one of these approaches for 12 months.

Participants that meet screening and eligibility will be randomized to one of the two diets. In addition to the diet, study specific visits and assessments will be performed at various timepoints.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
180
Inclusion Criteria
  • diagnosis of type 2 diabetes, with current HbA1c > 6.5% and < 12% (self-reported and then measured at screening)
  • ability to speak English (this is a group-based intervention)
  • ability to engage in light physical activity
  • willingness to be randomized to either type of diet
Exclusion Criteria
  • unable to provide informed consent
  • substance abuse, mental health, cognitive, or medical condition that would, in the opinion of the investigators, make it difficult for the individual to take part in the intervention, may alter key outcomes, or may require important diet modifications and includes conditions such as hypercalcemia or thyroid dysfunction
  • pregnant or planning to become pregnant in the next 12 months, or currently breastfeeding (pregnancy and breastfeeding require modifications to the intervention's dietary approaches)
  • current use of weight loss medications (this is likely to alter weight outcomes and may alter other measures)
  • history of weight loss (bariatric) surgery or plans for bariatric surgery in the next year
  • currently enrolled in a weight loss program or have unalterable plans to enroll in one of these programs in the next year
  • vegan or vegetarian
  • unwilling or unable to participate in study measurements and group classes
  • current use of systemic steroids (self-reported in screening survey; oral or IV systemic steroids excluded. Injected steroids may be permitted depending on frequency and timing of injections with regard to lab assessments (minimum of 2 weeks between injection and blood tests))
  • weight above 400 pounds (weight limit for dual-energy X-ray absorptiometry (DEXA) scans)
  • history of multiple or recent (within the last four years) kidney stones
  • currently following a very low-carbohydrate diet
  • unwilling to stop an SGLT2 inhibitor medication if the participant were to be randomized to the very low-carbohydrate diet

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Moderate-carbohydrate plate-method dietModerate-carbohydrate plate-method diet-
Very low-carbohydrate dietVery low-carbohydrate diet-
Primary Outcome Measures
NameTimeMethod
Change in HbA1c0 to 12 months

HbA1c will be measured by standard immunoturbidimetric assay methods and quality control measures at a Clinical Laboratory Improvement Amendments (CLIA) certified lab.

Secondary Outcome Measures
NameTimeMethod
Change in Inflammation based on high sensitivity C-reactive protein (hsCRP)0 to 12 months

High-sensitivity C-reactive protein will be measured with nephelometric methods utilizing latex particles coated with CRP monoclonal antibodies and standardized against a CRP reference preparation.

Change in high-density lipoproteins (HDL)0 to 12 months
Change in percent lean body mass on DEXA0 to 12 months

This will be measured by dual-energy X-ray absorptiometry scan

Change in HbA1c0 to 4 months

HbA1c will be measured by standard immunoturbidimetric assay methods and quality control measures at a Clinical Laboratory Improvement Amendments (CLIA) certified lab.

Change in bone mineral density in total hip0 to 12 months

This will be measured by dual-energy X-ray absorptiometry scan

Change in small particle low-density lipoproteins (LDL)0 to 12 months
Change in triglycerides0 to 12 months
Change in percent body fat on DEXA0 to 12 months

This will be measured by dual-energy X-ray absorptiometry scan

Change in bone mineral density in lumbar spine0 to 12 months

This will be measured by dual-energy X-ray absorptiometry scan

Reduction in diabetes medications using medication effect score (MES)0 to 12 months

The medication effect score is a means of assessing the overall intensity of a patient's diabetes pharmacotherapy based on potency and dosages of medications (Alexopoulos et al., 2021).

Change in percent body weight loss0 to 12 months
Change in serum procollagen type I N propeptide (s-PINP)0 to 12 months
Change in serum c-terminal telopeptide of type 1 collagen (s-CTX)0 to 12 months

Trial Locations

Locations (2)

University of MIchigan

🇺🇸

Ann Arbor, Michigan, United States

The University of California San Francisco (UCSF)

🇺🇸

San Francisco, California, United States

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