Moderate or Extensive Carbohydrate Reduction in Risk Patients

NCT ID: NCT03090074

Last Updated: 2019-10-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-20

Study Completion Date

2021-03-19

Brief Summary

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Risk-patients for diabetes or patients that are diagnosed with this condition but who are not treated with insulin are randomized two times, according to diet and according to the type of support:

Randomization with regard to carbohydrate restriction (25-30 E% or \< 10E%). Randomization with regard to type of psychological support. Either according to Acceptance and Commitment Therapy or to traditional cognitive behavioral therapy. Both kinds of psychological support is given as group therapy.

Two-hundred patients are recruited and each patient is followed for two years.

Detailed Description

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The organizers will recruit 200 patients in the study "To lower glucose levels and reduce weight by exclusion of carbohydrates and inclusion of psychological behavioral support" (LOWinCHIP) at the primary care health center "Cithyhälsan Centrum" in Norrköping. Each patient will be followed for 2 years. Patients are eligible if they have are above 18 years of age and have a BMI above 28 kg/m2 and also belong to one or more of the following groups: 1) type 2 diabetes that is not treated with insulin. 2) Patients that have had gestational diabetes or who have 3) first grade relative with type 2 diabetes. Finally 4) pre-diabetic individuals with impaired fasting glucose (6.1-6.9 mmol) or impaired glucose tolerance (capillary plasma glucose 8.9-12-1 after glucose challenge) are also potential participants. Patients must not have insulin therapy or severe kidney failure (GFR\< 30). They can also not have severe physical restrictions for activity and they must not have difficulties with understanding written Swedish texts.

The participants are randomized two times (two by two factorial):

Randomization with regard to carbohydrate restriction (25-30 E% or \< 10E%). Randomization with regard to type of psychological support. Either according to Acceptance and Commitment Therapy (ACT) or to traditional cognitive behavioral therapy. Each group will have three group sessions with approximately 8 participants followed by a telephone call by the therapist. Each session will be held by the psychologists that are part of the Cityhälsan Centrum staff.

The study has \> 95% power to demonstrate 5% HbA1c (mmol/mol) difference between groups with a drop out of 25%.

Conditions

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Glucose Metabolism Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Moderate carbohydrate restriction and traditional support

Moderate carbohydrate restriction and traditional support with group meetings

Group Type ACTIVE_COMPARATOR

Diet regime

Intervention Type BEHAVIORAL

Randomization to moderate or extreme low-carbohydrate Mediterranean diet advice.

Type of psychological support

Intervention Type BEHAVIORAL

Randomization to group-based psychological support according to ACT or to traditional cognitive behavioral therapy

Extreme low carbohydrate diet and traditional support

Extreme carbohydrate restriction and traditional support with group meetings

Group Type ACTIVE_COMPARATOR

Diet regime

Intervention Type BEHAVIORAL

Randomization to moderate or extreme low-carbohydrate Mediterranean diet advice.

Type of psychological support

Intervention Type BEHAVIORAL

Randomization to group-based psychological support according to ACT or to traditional cognitive behavioral therapy

Moderate carbohydrate restriction and ACT support

Moderate carbohydrate restriction and psychological support based on acceptance and commitment therapy

Group Type ACTIVE_COMPARATOR

Diet regime

Intervention Type BEHAVIORAL

Randomization to moderate or extreme low-carbohydrate Mediterranean diet advice.

Type of psychological support

Intervention Type BEHAVIORAL

Randomization to group-based psychological support according to ACT or to traditional cognitive behavioral therapy

Extreme carbohydrate restriction and ACT support

Extreme carbohydrate restriction and psychological support based on acceptance and commitment therapy

Group Type ACTIVE_COMPARATOR

Diet regime

Intervention Type BEHAVIORAL

Randomization to moderate or extreme low-carbohydrate Mediterranean diet advice.

Type of psychological support

Intervention Type BEHAVIORAL

Randomization to group-based psychological support according to ACT or to traditional cognitive behavioral therapy

Interventions

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Diet regime

Randomization to moderate or extreme low-carbohydrate Mediterranean diet advice.

Intervention Type BEHAVIORAL

Type of psychological support

Randomization to group-based psychological support according to ACT or to traditional cognitive behavioral therapy

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diabetes without insulin. Patients at high risk for developing diabetes.

Exclusion Criteria

* Severe kidney failure. Insulin therapy. Inability to understand instructions.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Linkoeping

OTHER

Sponsor Role lead

Responsible Party

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Fredrik H Nystrom

Professor, head of Internal Medicine, consultant in Endocrinology.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University Hospital of Linkoping

Linköping, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Fredrik H Nystrom, professor

Role: CONTACT

736569303 ext. +46

Facility Contacts

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Fredrik H Nystrom, MD, prof.

Role: primary

Other Identifiers

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LOWinCHIP

Identifier Type: -

Identifier Source: org_study_id

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