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
Authors' conclusion
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.
Study context
- Population
- Adults aged 19–30 years with T1D for ≥1 year and BMI 27–39.9 kg/m²28 for hypoglycaemia indices
- Participants
- 38 adults
- Comparison
- Hypocaloric low carbohydrate vs hypocaloric moderate low fat vs Mediterranean diet without calorie restriction
- Primary endpoint
- Weight, HbA1c, percentage of time below range <70 mg/dl
- Follow-up
- Initial 3-month diet period
Methodological detailspilot, re-randomization at 3 and 6 months if diet not acceptable or not effective, Results reported before shutdowns due to COVID-19
- Pilot
- Re-randomization at 3 and 6 months if diet not acceptable or not effective
- Results reported before shutdowns due to COVID-19
Primary result
As reported in the abstract
Weight, HbA1c and time below range <70 mg/dl (adjusted change, all diets) · 3 months
Adjusted weight change
−2.7 kg
95% CI −3.8, −1.5P < .0001
Adjusted haemoglobin A1c (HbA1c) change
−0.91 percentage points
95% CI −1.5, −0.30P = .005
Hypoglycaemia indices unchanged after adjustment
n = 28
P > .05
Secondary outcomes
Body fat percentage · 3 months
- Adjusted body fat percentage remained stable, on average
- P = 0.21
Re-randomization
- Re-randomized, primarily due to loss of <2% body weight
- 57.9%
Safety
Hypoglycaemia · 3 months
- Hypoglycaemia indices remained unchanged following adjustment
- n = 28, P > .05
Original publication
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. Diabetes Obes Metab. Published 21 November 2022. doi:10.
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