Advertisement
Examining Diets for Patients With Diabetes

Examining Diets for Patients With Diabetes

Studies of patients with type 2 diabetes have shown that a low-carbohydrate diet can achieve at least comparable reductions in body weight, blood pressure, and insulin concentrations when compared with a high-carbohydrate diet. A low-carbohydrate diet can also lead to greater improvements in glycemic control, according to some studies. To better understand the impact of dietary carbohydrates on diabetes control, William S. Yancy Jr., MD, and colleagues performed a comprehensive comparison that was published in Diabetes Care. The researchers examined the effects of a very low-carbohydrate, high-unsaturated/low-saturated fat diet (LC) with those of a high-unrefined carbohydrate, low-fat diet (HC) on glycemic control and cardiovascular disease risk factors in type 2 diabetes. For the study, overweight and obese adults with type 2 diabetes were randomized to LC—which consisted of 14% carbohydrates, 28% proteins, and 58% fats—or an energy-matched HC—which consisted of 53% carbohydrates, 17% proteins, and 30% fats. Both diets had less than 10% saturated fat. “All participants met regularly over the 6-month study, were taught about their respective diets, and were provided some of the foods,” says Dr. Yancy. “They were also enrolled in a physical activity program in which they were monitored for 60 minutes at an exercise facility at least three times per week.” Important Findings Based on various measures, the researchers found that LC led to greater glycemic control and achieved greater reductions in triglycerides, anti-glycemic medication scores, and glycemic variability. “A1C also improved more with LC than with HC in patients who had out-of-control A1C at the beginning of the study,” explains Dr. Yancy. “By reducing the number of medications needed to control blood sugar,...
Patient Preferences for Non-Insulin Diabetes Drugs

Patient Preferences for Non-Insulin Diabetes Drugs

As type 2 diabetes has become a more manageable chronic condition, there has been a recent push to implement patient-centered care approaches for those with the disease. “Studies have shown that type 2 diabetes is often poorly controlled, and adherence to insulin and non-insulin medications is frequently suboptimal,” explains Tanjala S. Purnell, PhD, MPH. “This can increase patients’ risk for developing cardiovascular disease, chronic kidney disease, and other health problems. Understanding why patients prefer certain treatments for their diabetes is an important and necessary part of achieving patient-centered care.” The issue of treatment preference in type 2 diabetes is complex because there is a wide range of medication options. With these options comes consideration of drug-related benefits, harms, and burden as well as the likelihood or uncertainty of treatment-related outcomes. When measuring patient preferences, Dr. Purnell says it is important to determine how patients value specific outcomes, such as the importance of weight maintenance or glycemic control. It is also important to measure how patients choose between treatment options and how their choices are influenced by particular attributes of treatment. A Systematic Review Although patient preferences are deemed important by major diabetes professional societies, little is known about how these preferences influence treatment for type 2 diabetes. To address this research gap, Dr. Purnell and colleagues conducted a systematic review that identified and analyzed studies of patient preferences in patients with type 2 diabetes not on insulin. The study, published in Diabetes Care, reviewed several databases for articles in which patient preferences for diabetes medication treatment were assessed. For the analysis, many important attributes were examined in clinical studies...
[ HIDE/SHOW ]