Low Glycemic Index Diet for Type 2 Diabetics
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Purpose
A low glycemic index diet may improve glycemic control and reduce plaque buildup in arteries of those with type 2 diabetes. Subjects will be randomly assigned to receive dietary advice on either a low glycemic index diet, or a high cereal fibre diet, for three years.
| Condition | Intervention | Phase |
|---|---|---|
|
Type 2 Diabetes |
Dietary Supplement: low glycemic diet instruction Dietary Supplement: high cereal fibre diet instruction |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Low Glycemic Index Diets to Improve Glycemic Control and Cardiovascular Disease in Type 2 Diabetics |
- plaque volume [ Time Frame: 1, 3 years ] [ Designated as safety issue: Yes ]
- intima media thickness [ Time Frame: 0, 1, and 3 years ] [ Designated as safety issue: Yes ]
- plaque morphology [ Time Frame: 0, 1, 3 years ] [ Designated as safety issue: Yes ]
- HbA1c [ Time Frame: every 3 months for 3 years ] [ Designated as safety issue: Yes ]
- serum lipids [ Time Frame: every 3 months for 3 years ] [ Designated as safety issue: Yes ]
- blood pressure [ Time Frame: every 3 months for 3 years ] [ Designated as safety issue: Yes ]
- serum fasting glucose [ Time Frame: creatinine, urea, and C-peptides in 24 hour urine collection ] [ Designated as safety issue: Yes ]
- anthropometric measures (weight, waist and hip circumference) [ Time Frame: every 3 months for 3 years ] [ Designated as safety issue: Yes ]
- retinal photography [ Designated as safety issue: Yes ]opthalmological assessment using fundoscopy
| Estimated Enrollment: | 160 |
| Study Start Date: | March 2010 |
| Estimated Primary Completion Date: | September 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: low glycemic index, diabetic diet | Dietary Supplement: low glycemic diet instruction |
| Active Comparator: high cereal fibre, diabetic diet | Dietary Supplement: high cereal fibre diet instruction |
Detailed Description:
All subjects will be randomized to one 3-year treatment in a two-treatment parallel design.
Treatments:
- low glycemic index dietary advice (e.g. to eat intact grain cereals, Pita Break Finland Rye and Little Stream Quinoa breads, parboiled rice, cracked wheat, pasta, peas, beans, lentils, and baked goods made from legume flour); or
- a high cereal fiber diet emphasizing whole grains. Duration: The study will consist of approximately two months of recruitment and patient selection, during which time estimation of individual caloric requirements will be assessed, and a 3 year treatment period assigned.
Study Details: Fasting blood samples are obtained at screening, week -2, and months 0, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33 and 36 each study period. HbA1c will be assessed on all visits. A carotid ultrasound (CUS) (screening, months 0, 12 and 36) and magnetic resonance imaging (MRI) (months 0, 12 and 36) technologies will be used to assess arterial wall thickening and changes in the nature of carotid plaques. Twenty-four hour urine for urinary C-peptide analyses will be obtained immediately prior to the beginning of the study and at the end of each 3 year treatment phase. At the end of the 3 year treatment period, subjects who wish to undertake the alternate treatment will be given appropriate instruction.
Eligibility| Ages Eligible for Study: | 21 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Men and women with type 2 diabetes who
- are treated with oral hypoglycemic agents at a stable dose for at least 8 weeks
- have a HbA1c in the range of 6.5 to 8.0% at screening and at the prestudy visit
- have diabetes diagnosed >6 months
- have maintained stable weight for 2 months (within 3%)
- have a valid OHIP card and a family physician
- if prescribed lipid medication, have taken a stable dose for at least 2 weeks
- if prescribed blood pressure medication, have taken a stable dose for at least 1 week
- can keep written food records, with the use of a digital scale
Exclusion Criteria: Individuals who
- take insulin
- take steroids
- have GI disease (gastroparesis, celiac disease, ulcerative colitis, Crohn's Disease, IBS)
- have had a major cardiovascular event (stroke or myocardial infarction) in the past 6 months
- take warfarin (Coumadin)
- have had major surgery in the past 6 months
- have a major debilitating disorder
- have clinically significant liver disease (AST or ALT > 130 U/L), excluding NAFL or NASH
- have hepatitis B or C
- have renal failure (high creatinine > 150 mmol/L)
- have serum triglycerides ≥ 6.0 mmol/L
- have a history of cancer, except non-melanoma skin cancer (basal cell, squamous cell)
- have food allergies to study food components
- have elevated blood pressure (> 145/90) unless approved by GP
- have acute or chronic infections (bacterial or viral)
- have chronic inflammatory diseases (e.g. rheumatoid arthritis, lupus; ulcerative colitis)
- have other conditions which in the opinion of any of the investigators would make them unsuitable for the study
- If HbA1c rises above 8.5% over two consecutive routine measurements, subjects will be referred back to their family doctors for an increase in anti hyperglycemic medications according to a predetermined protocol.
- Any condition or circumstance which would prevent an individual from having an MRI (e.g. individuals with prostheses or metal implants, or those who are excessively claustrophobic)
Contacts and Locations| Contact: David JA Jenkins, MD | 416-867-7475 | NutritionProject@smh.toronto.on.ca |
| Contact: Cyril Kendall, PhD | 416-978-6527 | cyril.kendall@utoronto.ca |
| Canada, Ontario | |
| Clinical Nutrition & Risk Factor Modification Centre, St. Michael's Hospital Health Centre | Recruiting |
| Toronto, Ontario, Canada, M5C 2T2 | |
| Contact: Sandy Mitchell 416-867-7474 mitchells@smh.toronto.on.ca | |
| Principal Investigator: David JA Jenkins, MD, PhD, DSc | |
| Sunnybrook Health Sciences Centre | Active, not recruiting |
| Toronto, Ontario, Canada, M4N 3M5 | |
More Information
No publications provided
| Responsible Party: | David Jenkins, Principle Investigator, University of Toronto |
| ClinicalTrials.gov Identifier: | NCT01063374 History of Changes |
| Other Study ID Numbers: | 09-193 |
| Study First Received: | February 3, 2010 |
| Last Updated: | June 12, 2012 |
| Health Authority: | Canada: Health Canada |
Additional relevant MeSH terms:
|
Cardiovascular Diseases Diabetes Mellitus, Type 2 Diabetes Mellitus |
Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on May 16, 2013