Mixed methods pilot study of a low-carbohydrate diabetes prevention programme among adults with pre-diabetes in the USA.

Abstract

OBJECTIVES:

(1) To estimate weight change from a low-carbohydrate diabetes prevention programme (LC-DPP) and (2) to evaluate the feasibility and acceptability of an LC-DPP.

RESEARCH DESIGN:

Single-arm, mixed methods (ie, integration of quantitative and qualitative data) pilot study.

SETTING:

Primary care clinic within a large academic medical centre in the USA.

PARTICIPANTS:

Adults with pre-diabetes and Body Mass Index of ≥25 kg/m2.

INTERVENTION:

We adapted the Centers for Disease Control and Prevention's National Diabetes Prevention Program (NDPP)-an evidence-based, low-fat dietary intervention-to teach participants to follow a very low-carbohydrate diet (VLCD). Participants attended 23 group-based classes over 1 year.

OUTCOME MEASURES:

Primary outcome measures were (1) weight change and (2) percentage of participants who achieved ≥5% wt loss. Secondary outcome measures included intervention feasibility and acceptability (eg, attendance and qualitative interview feedback).

RESULTS:

Our enrolment target was 22. One person dropped out before a baseline weight was obtained; data from 21 individuals were analysed. Mean weight loss in kilogram was 4.3 (SD 4.8) at 6 months and 4.9 (SD 5.8) at 12 months. Mean per cent body weight changes were 4.5 (SD 5.0) at 6 months and 5.2 (SD 6.0) at 12 months; 8/21 individuals (38%) achieved ≥5% wt loss at 12 months. Mean attendance was 10.3/16 weekly sessions and 3.4/7 biweekly or monthly sessions. Among interviewees (n=14), three factors facilitated VLCD adherence: (1) enjoyment of low-carbohydrate foods, (2) diminished hunger and cravings and (3) health benefits beyond weight loss. Three factors hindered VLCD adherence: (1) enjoyment of high-carbohydrate foods, (2) lack of social support and (3) difficulty preplanning meals.

CONCLUSIONS:

An LC-DPP is feasible, acceptable and may be an effective option to help individuals with pre-diabetes to lose weight. Data from this pilot will be used to plan a fully powered randomised controlled trial of weight loss among NDPP versus LC-DPP participants.

TRIAL REGISTRATION NUMBER:

NCT03258918.

• Authors: Dina Hafez Griauzde, Laura Saslow, Kaitlyn Patterson, Tahoora Ansari, Bradley Liestenfeltz, Aaron Tisack, Patti Bihn, Samuel Shopinski, Caroline R Richardson
• Journal: BMJ open (BMJ Open) Vol. 10 Issue 1 Pg. e033397 (01 21 2020) ISSN: 2044-6055 [Electronic] England
• PMID: 31969366 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Dietary Carbohydrates

Topics

• Body Mass Index
• Diabetes Mellitus (prevention & control)
• Dietary Carbohydrates (pharmacology)
• Exercise (physiology)
• Female
• Humans
• Life Style
• Male
• Middle Aged
• Pilot Projects
• Prediabetic State (prevention & control)
• Weight Loss (physiology)
• Weight Reduction Programs (methods)