Weight management in young adults with type 1 diabetes: The advancing care for type 1 diabetes and obesity network sequential multiple assignment randomized trial pilot results.
Study Goal
The researchers aimed to evaluate the effects of a hypocaloric low-carbohydrate diet, hypocaloric moderate low-fat diet, and Mediterranean diet on weight and glycaemia in young adults with type 1 diabetes and overweight or obesity.
Results Summary
The study found that three months of any of the tested diets resulted in weight loss and improved or maintained HbA1c levels without increasing hypoglycaemia. However, variability in outcomes was considerable, and no significant differences were observed between the diets.
Population
Young adults aged 19-30 years with type 1 diabetes for ≥1 year and a BMI of 27-39.9 kg/m².
Effective Dosage
Not specified
Duration
9 months (with 3-month initial intervention phase)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | decrease | weight | young adults with T1D and overweight or obesity | -2.7 kg (95% CI -3.8, -1.5, P < .0001) | changed by | #1 |
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | decrease | HbA1c | young adults with T1D and overweight or obesity | -0.91 percentage points (95% CI -1.5, -0.30, P = .005) | changed by | #2 |
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | no change | body fat percentage | young adults with T1D and overweight or obesity | P = .21 | remained stable, on average | #3 |
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | no change | hypoglycaemia indices | young adults with T1D and overweight or obesity | P > .05 | remained unchanged | #4 |
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | decrease | weight loss | adults with T1D | - | resulted in | #5 |
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | decrease | HbA1c levels | adults with T1D | - | improving or maintaining | #6 |
a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction | no change | hypoglycaemia | adults with T1D | - | without increasing | #7 |
AIMS: Co-management of weight and glycaemia is critical yet challenging in type 1 diabetes (T1D). We evaluated the effect of a hypocaloric low carbohydrate, hypocaloric moderate low fat, and Mediterranean diet without calorie restriction on weight and glycaemia in young adults with T1D and overweight or obesity. MATERIALS AND METHODS: We implemented a 9-month Sequential, Multiple Assignment, Randomized Trial pilot among adults aged 19-30 years with T1D for ≥1 year and body mass index 27-39.9 kg/m RESULTS: Adjusted weight and HbA1c (n = 38) changed by -2.7 kg (95% CI -3.8, -1.5, P < .0001) and -0.91 percentage points (95% CI -1.5, -0.30, P = .005), respectively, while adjusted body fat percentage remained stable, on average (P = .21). Hypoglycaemia indices remained unchanged following adjustment (n = 28, P > .05). Variability in all outcomes, including weight change, was considerable (57.9% were re-randomized primarily due to loss of <2% body weight). No outcomes varied by diet. CONCLUSIONS: Three months of a diet, irrespective of macronutrient distribution or caloric restriction, resulted in weight loss while improving or maintaining HbA1c levels without increasing hypoglycaemia in adults with T1D.