Type 2 Diabetes Prevention Focused on Normalization of Glycemia: A Two-Year Pilot Study

Nutrients. 2021 Feb 26;13(3):749. doi: 10.3390/nu13030749.

Abstract

The purpose of this study is to assess the effects of an alternative approach to type 2 diabetes prevention. Ninety-six patients with prediabetes (age 52 (10) years; 80% female; BMI 39.2 (7.1) kg/m2) received a continuous remote care intervention focused on reducing hyperglycemia through carbohydrate restricted nutrition therapy for two years in a single arm, prospective, longitudinal pilot study. Two-year retention was 75% (72 of 96 participants). Fifty-one percent of participants (49 of 96) met carbohydrate restriction goals as assessed by blood beta-hydroxybutyrate concentrations for more than one-third of reported measurements. Estimated cumulative incidence of normoglycemia (HbA1c <5.7% without medication) and type 2 diabetes (HbA1c ≥6.5% or <6.5% with medication other than metformin) at two years were 52.3% and 3%, respectively. Prevalence of metabolic syndrome, class II or greater obesity, and suspected hepatic steatosis significantly decreased at two years. These results demonstrate the potential utility of an alternate approach to type 2 diabetes prevention, carbohydrate restricted nutrition therapy delivered through a continuous remote care model, for normalization of glycemia and improvement in related comorbidities.

Keywords: low carbohydrate, metabolic syndrome, obesity; prediabetes; remote continuous care.

Publication types

  • Clinical Trial

MeSH terms

  • 3-Hydroxybutyric Acid / blood
  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet, Carbohydrate-Restricted / methods*
  • Fatty Liver / epidemiology
  • Fatty Liver / etiology
  • Fatty Liver / prevention & control
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / complications
  • Hyperglycemia / diet therapy*
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / diet therapy
  • Metabolic Syndrome / etiology
  • Middle Aged
  • Obesity / epidemiology
  • Obesity / etiology
  • Obesity / prevention & control
  • Patient Education as Topic
  • Pilot Projects
  • Prediabetic State / blood
  • Prediabetic State / complications
  • Prediabetic State / diet therapy*
  • Prevalence
  • Prospective Studies
  • Telemedicine / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • 3-Hydroxybutyric Acid

Grant support