Low Glycemic Index Diet Therapy in Children With Refractory Epilepsy
|ClinicalTrials.gov Identifier: NCT01645072|
Recruitment Status : Unknown
Verified July 2012 by Sheffali Gulati, All India Institute of Medical Sciences, New Delhi.
Recruitment status was: Recruiting
First Posted : July 20, 2012
Last Update Posted : July 20, 2012
|Condition or disease||Intervention/treatment||Phase|
|Refractory Epilepsy||Other: Low glycemic index diet Other: Control group||Phase 3|
Each patient will undergo detailed clinical evaluation according to a structured proforma. Seizure type, frequency, age at onset, perinatal details, family history, developmental status and treatment history will be recorded. Corticosteroids or ACTH (if patient is already on) would be tapered off 2 weeks before starting LGIT. All co-medications will be changed to carbohydrate free preparations, wherever available only in the intervention group.
Eligible patients will be randomized in to two groups: the intervention and the control arm. Both groups will undergo a baseline four week observation period, during which parents will be asked to maintain a daily seizure log; recording seizure type, duration and frequency. In the intervention arm, the children will be started on low glycemic index diet after this 4-week baseline period. The control group will receive their usual diet without any alteration. No changes will be made to the patients' antiepileptic medication during the 4-week baseline or the 3-month study periods in both the intervention and control groups, unless medically indicated; e.g. drug side effects, or status epilepticus; in which case appropriate changes will be made to their medications and same will be documented. The drop out from the intervention group will be documented along with the reason for the same. At the end of the 3 month study period patient in the intervention arm will be continued with the LGIT but that will not come under the purview of this study. At the end of three months study period, patients in the control arm will be offered the option of low glycemic index diet treatment.
Low glycemic index diet administration
- Three day food intake by recall method will be documented
- The calorie requirement would be calculated as per the recommended daily allowance (RDA) for the ideal weight for that age
- Diet regime will be explained to the parents
- Patients (wherever applicable) and their parents will be given diet counseling
- LGIT will be started on out patient basis.
- Medium and high-GI carbohydrates (GI >55) will be eliminated from the diet and only food items with low glycemic index (GI <55) will be allowed. Parent will be given a list of low glycemic index food items33. They will also be given a list of food items (medium and high glycemic index) which should be avoided. (Appendix)
- Total carbohydrates intake will be restricted to 10% of caloric intake/ day (maximum 40-60 g/day).
- Carbohydrate values of various food items will be explained in detail, and carbohydrate exchange lists will be provided to the parent. Three to four 15 gram carbohydrate exchanges will be allowed in a day. (Appendix)
- Fats (e.g. cream, butter, oils and ghee) can be taken by the patient without any restriction.
- Proteins intake will be allowed up to 30% of the total caloric intake per day (cheese, fish, eggs, chicken and soya products).
- Sample menu will be discussed with the parent.
- Clear carbohydrate free fluids will not be restricted.
Follow up Children will be reviewed as outpatients at 1, 2 and 3 months. A three day dietary intake chart will be reviewed at each visit to compute calorie and carbohydrate intake, and to evaluate and reinforce compliance with the prescribed diet. Weight will be checked at each visit.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||40 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||Efficacy of Low Glycemic Index Diet Therapy in Children With Refractory Epilepsy - A Randomized Controlled Trial|
|Study Start Date :||June 2011|
|Estimated Primary Completion Date :||August 2012|
|Estimated Study Completion Date :||October 2012|
Experimental: Low glycemic index diet
The patients will be started on low glycemic index diet.
Other: Low glycemic index diet
Diet modification in addition to ongoing anti epileptic drug treatment. Medium and high-GI carbohydrates (GI >55) will be eliminated from the diet and only food items with low glycemic index (GI <55) will be allowed. Parent will be given a list of low glycemic index food items. They will also be given a list of food items (medium and high glycemic index) which should be avoided.
Standard care. The control group will receive their usual diet without any alteration. No changes will be made to the patients' antiepileptic medication during the 4-week baseline or the 3-month study periods in both the intervention and control groups, unless medically indicated; e.g. drug side effects, or status epilepticus; in which case appropriate changes will be made to their medications and same will be documented.
Other: Control group
The ongoing anti epileptic drug treatment will be continued without change.
- Seizure control [ Time Frame: 3 months ]Proportion of patients who achieve > 50% seizure reduction (Seizure frequency measured as average seizure per week in the preceding 4 week period) from the baseline
- Adverse events [ Time Frame: 3 months ]Proportion and nature of adverse events in both the groups
- Withdrawal rate [ Time Frame: 3 months. ]Proportion of patients withdrawing from the LGIT plus antiepileptic drug treatment group during the study period and reasons for withdrawal.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01645072
|Contact: Sheffali Gulati, MDfirstname.lastname@example.org|
|All India Institute of Medical Sciences||Recruiting|
|New Delhi, Delhi, India, 110029|
|Contact: Lakshminarayanan K, MD 919013232893 email@example.com|
|Contact: Sheffali Gulati +91-11-26594679 firstname.lastname@example.org|
|Principal Investigator:||Sheffali Gulati, MD||All India Institute of Medical Sciences, New Delhi|