A Pilot Study of the Effects of Diet and Behavioral Interventions on Health in Diabetics (SUCCEED)
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Purpose
The study is a small pilot, designed to provide data regarding the feasibility and acceptability of conducting such a study on a larger scale. The present study is a randomized controlled clinical trial comparing two mindfulness-based lifestyle modification programs to help people manage diabetes and lose weight, one using on a low-carbohydrate diet (LC) and the other using a moderate-carbohydrate diet promoted by the American Diabetes Association (ADA). Intervention content will include information about nutrition (carbohydrate restriction or American Diabetes Association recommended diet) and emotion regulation and mindful eating strategies.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Type II |
Behavioral: Low Carbohydrate Diet Behavioral: American Diabetes Association Diet Behavioral: Mindfulness and Positive Affect Skills |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Pilot Study of the Effects of Diet and Behavioral Interventions on Health in Diabetics |
- Hemoglobin A1c [ Time Frame: Change from baseline to 3 months ] [ Designated as safety issue: No ]We test whether Hemoglobin A1c changes from pre-intervention to 3 months. The key outcome measure will compare the two diet groups, but we will also assess whether statistically significant changes occur within groups from pre-intervention to 3 months.
- Hemoglobin A1c [ Time Frame: Change from baseline to 6 months ] [ Designated as safety issue: No ]We test whether Hemoglobin A1c changes from pre-intervention to 6 months. The key outcome measure will compare the two diet groups, but we will also assess whether statistically significant changes occur within groups from pre-intervention to 6 months.
| Estimated Enrollment: | 40 |
| Study Start Date: | October 2012 |
| Estimated Study Completion Date: | October 2013 |
| Estimated Primary Completion Date: | October 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Low Carbohydrate Diet
Participants will be instructed to follow a low carbohydrate diet: carbohydrate intake 10-50 grams a day not including fiber. Foods permitted include: meats, poultry, fish, eggs, cheese, cream, some nuts and seeds, green leafy vegetables, and most other non-starchy vegetables. Because most individuals self-limit caloric intake, no calorie restriction will be recommended. Participants will also be taught information about mindfulness and positive affect practices. The mindfulness-based curriculum will focus on the following elements: training on topics such as mindful meditation, mindful eating, awareness of fullness and hunger signals, and taste satiety. The positive emotion curriculum will include: training on topics such as noticing and savoring positive events, gratitude, positive reappraisal, personal strengths, attainable goals, and acts of kindness. |
Behavioral: Low Carbohydrate Diet Behavioral: Mindfulness and Positive Affect Skills |
|
Active Comparator: American Diabetes Association Diet
Participants in the American Diabetes Association (ADA) diet group will receive standard ADA advice. The diet includes high-fiber foods (such as vegetables, fruits, whole grains, and legumes), low-fat dairy products, fresh fish, and foods low in saturated fat. Participants will also be taught information about mindfulness and positive affect practices. The mindfulness-based curriculum will focus on the following elements: training on topics such as mindful meditation, mindful eating, awareness of fullness and hunger signals, and taste satiety. The positive emotion curriculum will include: training on topics such as noticing and savoring positive events, gratitude, positive reappraisal, personal strengths, attainable goals, and acts of kindness. |
Behavioral: American Diabetes Association Diet Behavioral: Mindfulness and Positive Affect Skills |
Detailed Description:
Approximately 40 individuals with Type II diabetes or prediabetes will be randomized in a 1:1 ratio to treatment groups. Groups will meet for 12 weekly sessions, then approximately biweekly for 3 sessions, for a total of 15 1.5-2 hour sessions over 4.5 months. Participants will be evaluated at 0, 1 month, 3 months, and 6 months. Our outcome of interest is HbA1c (glycated hemoglobin, a measure indicative of blood glucose levels and tied to diabetes severity).
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diabetes mellitus, Type 2.
- HgbA1c > 6.0% at screening. This is to confirm the diabetes diagnosis.
- Aged 18 years old and older
- BMI 25 and above.
Exclusion Criteria:
Condition that will make it difficult for participation. Such as:
- cancer
- liver failure
- unstable coronary artery disease
- severe emphysema
- bulimia or strong history of bulimia
- vegan
Laboratory evidence of organ dysfunction
- Abnormal kidney function (serum creatinine)
- thyroid stimulating hormone out of normal range
Previous use or new changes in medications that can interfere with the measures used in the study:
- current use of insulin and no immediate plans to start or increase diabetic mediations.
- more than 3 oral hypoglycemic medications.
- use of systemic (oral or IV) corticosteroids in the 6 months prior
- severe autoimmune disorders
- initiation of psychiatric medications in past 2 months.
Weight loss confounds
- Current use of weight loss medications or supplements.
- History of or planned weight loss surgery.
Other
- Pregnant or planning to get pregnant in the next year, breastfeeding, less than 6 months post-partum.
- Unable or unwilling to do home glucose monitoring.
Contacts and Locations| United States, California | |
| Osher Center for Integrative Medicine | |
| San Francisco, California, United States, 94143 | |
| Principal Investigator: | Frederick M Hecht, M.D. | University of California, San Francisco |
More Information
No publications provided
| Responsible Party: | University of California, San Francisco |
| ClinicalTrials.gov Identifier: | NCT01713764 History of Changes |
| Other Study ID Numbers: | 12-09549 |
| Study First Received: | August 24, 2012 |
| Last Updated: | November 26, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, San Francisco:
|
diabetes obesity mindful eating |
positive affect low carbohydrate diet |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on May 22, 2013