search
Back to results

The Effect of 3 Different Models of MNT on DM Control in Overweight Patients With T2DM

Primary Purpose

Type 2 Diabetes, Obesity

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Traditional MNT
Structured MNT
Structured MNT plus Weekly Support
Sponsored by
Joslin Diabetes Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes focused on measuring Type 2 diabetes, Obesity, Nutrition, Medical Nutrition Therapy

Eligibility Criteria

30 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject has voluntarily signed and dated an informed consent form, approved by an Institutional Review Board/Independent Ethics Committee, and provided Health Insurance Portability and Accountability Act authorization (HIPAA) or other privacy authorization prior to any participation in study.
  2. Subject states that he/she had type 2 diabetes, as evidenced by use of anti-hyperglycemic medication or managed on lifestyle intervention only with A1C >7%
  3. Subject is between 30 and 80 years of age.
  4. Subject on stable dose of antihyperglycemic medications for the past 3 months or lifestyle intervention
  5. Subject is a male or a non-pregnant, non-lactating female, at least 6 weeks postpartum prior to screening visit. A urine pregnancy test is required for all female subjects unless she is not of childbearing potential, defined as postmenopausal for at least one year prior to screening visit or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy).
  6. If a female is of childbearing potential, she is practicing one of the following methods of birth control (and continued through the duration of the study):

    • Condoms, sponge, diaphragm or intrauterine device;
    • Oral or parenteral contraceptives for 3 months prior to screening visit;
    • Vasectomized partner;
    • Total abstinence from sexual intercourse.
  7. Subject's BMI is > 25 kg/m2.
  8. Subject has A1C between 7-10%
  9. If on a chronic medication such as anti-hypertensive, lipid-lowering, thyroid medication or hormone therapy, subject has been on stable dose for at least three months prior to screening visit. These medications will not be changed during intervention unless it is mandatory.

Exclusion Criteria:

  1. Subjects using exogenous insulin since insulin titration may impact the primary endpoint.
  2. Subject states that he/she had a history of diabetic ketoacidosis.
  3. Subject is pregnant or lactating.
  4. Subject uses corticosteroid treatment with the exception of inhaled or topical steroids in the last 3 months; or antibiotics within the last 3 weeks prior to the screening visit.
  5. Subject states that he/she had an active malignancy (excluding the following dermal malignancies: basal cell carcinoma, squamous cell carcinoma, carcinoma in-situ of the cervix).
  6. Subject states that he/she has had a recent cardiovascular event (e.g., myocardial infarction, stroke) ≤ six months prior to screening visit; or stated history of congestive heart failure.
  7. Subject states that he/she has had end stage organ failure (such as end stage renal disease) or had status post organ transplant.
  8. Subject states that he/she has had a history of renal disease (Creatinine >1.5mg/dL or GFR <60 mL/min/1.73 m2).
  9. Subject states that he/she has had current hepatic disease.
  10. Subject has history of gastroparesis.
  11. Subject states that he/she has had a chronic, contagious, infectious disease
  12. Subject states that he/she has had clotting or bleeding disorders.
  13. Subject is known to be allergic or intolerant to any ingredient found in the study products.
  14. Subject is known to have a history of special nutritional need requiring special diet.
  15. Subject is currently participating in any weight loss program.
  16. Subject has used meal replacements during the 3 months prior to the start of the study.
  17. Subject has history of bariatric surgery.

    -

Sites / Locations

  • Joslin Diabetes Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

Traditional MNT

Structured MNT

Structured MNT plus Weekly Support

Arm Description

Will be instructed to follow a MNT plan as recommended by the ADA through consultation with a RD.

Will be instructed to follow a MNT plan as applied in the Why WAIT™ program, which includes structured dietary plan, dietary modification and use of diabetes-specific meal replacement (Ultra Glucose Control®; Metagenics Inc.) three times per day.

Will be instructed to follow a MNT plan as applied in the Why WAIT™ program, which includes structured dietary plan, dietary modification and use of diabetes-specific meal-replacement (Ultra Glucose Control®; Metagenics Inc.) three times per day plus weekly coaching.

Outcomes

Primary Outcome Measures

Absolute and relative change in HbA1c

Secondary Outcome Measures

Absolute and relative change in body weight
Absolute and relative change in fasting blood glucose
Absolute and relative change in lipid profile (cholesterol, HDL, LDL, triglycerides)
Absolute and relative change in blood pressure
Absolute and relative change in High-sensitivity C - reactive protein (hsCRP)
Absolute and relative change in HOMA insulin resistance (IR) index
Absolute and relative change in c-peptide level
Absolute and relative change in microalbumin/creatinine ratio
Absolute and relative change in fat mass
Absolute and relative change in body fat percentage
Absolute and relative change in waist/hip ratio
Absolute and relative change in visceral fat content
Absolute and relative change in dietary protein
Absolute and relative change in energy intake

Full Information

First Posted
August 4, 2015
Last Updated
February 28, 2019
Sponsor
Joslin Diabetes Center
Collaborators
Metagenics, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT02520050
Brief Title
The Effect of 3 Different Models of MNT on DM Control in Overweight Patients With T2DM
Official Title
The Effect of Three Different Models of Medical Nutrition Therapy (MNT) on Diabetes Control in Overweight and Obese Patients With Type 2 Diabetes: A Randomized Comparative Study. (Nutrition Path Study)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
April 2015 (undefined)
Primary Completion Date
July 2018 (Actual)
Study Completion Date
July 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Joslin Diabetes Center
Collaborators
Metagenics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The American Diabetes Association (ADA), among other medical societies, is strongly recommending medical nutrition therapy (MNT) for prevention and management of type 2 diabetes. However, the ADA recognized that there is no "one size fits all" diet and thus recommends that MNT should be conducted through a consultation with registered dietitians (RD). Previous studies have shown that using diabetes-specific nutritional formulas, as an integral part of the MNT, lowers postprandial blood glucose levels. Through our experience from the Joslin's Weight Achievement and Intensive Treatment (Why WAIT™) program, applying MNT within a structured dietary intervention protocol has the best impact on blood glucose values and body weight. Meanwhile, the frequent use of health coaching during dietary intervention proved to be effective in managing diabetes and inducing weight loss. However, no study compared those three intervention methods in a randomized clinical study. The aim of this study is to evaluate the effect of different models of conducting medical nutrition therapy on the glycemic control in patients with type 2 diabetes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes, Obesity
Keywords
Type 2 diabetes, Obesity, Nutrition, Medical Nutrition Therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
108 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Traditional MNT
Arm Type
Active Comparator
Arm Description
Will be instructed to follow a MNT plan as recommended by the ADA through consultation with a RD.
Arm Title
Structured MNT
Arm Type
Active Comparator
Arm Description
Will be instructed to follow a MNT plan as applied in the Why WAIT™ program, which includes structured dietary plan, dietary modification and use of diabetes-specific meal replacement (Ultra Glucose Control®; Metagenics Inc.) three times per day.
Arm Title
Structured MNT plus Weekly Support
Arm Type
Active Comparator
Arm Description
Will be instructed to follow a MNT plan as applied in the Why WAIT™ program, which includes structured dietary plan, dietary modification and use of diabetes-specific meal-replacement (Ultra Glucose Control®; Metagenics Inc.) three times per day plus weekly coaching.
Intervention Type
Behavioral
Intervention Name(s)
Traditional MNT
Intervention Description
Will follow the nutritional recommendations set by the American Diabetes Association in 2013.
Intervention Type
Behavioral
Intervention Name(s)
Structured MNT
Other Intervention Name(s)
Medical Nutritional Therapy Plan
Intervention Description
Will follow a meal plan developed at Joslin plus use of use of diabetes-specific nutritional formula.
Intervention Type
Behavioral
Intervention Name(s)
Structured MNT plus Weekly Support
Intervention Description
Will follow a meal plan developed at Joslin plus use of use of diabetes-specific nutritional formula; in addition to receiving weekly coaching from a registered dietitian
Primary Outcome Measure Information:
Title
Absolute and relative change in HbA1c
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Absolute and relative change in body weight
Time Frame
16 weeks
Title
Absolute and relative change in fasting blood glucose
Time Frame
16 weeks
Title
Absolute and relative change in lipid profile (cholesterol, HDL, LDL, triglycerides)
Time Frame
16 weeks
Title
Absolute and relative change in blood pressure
Time Frame
16 weeks
Title
Absolute and relative change in High-sensitivity C - reactive protein (hsCRP)
Time Frame
16 weeks
Title
Absolute and relative change in HOMA insulin resistance (IR) index
Time Frame
16 weeks
Title
Absolute and relative change in c-peptide level
Time Frame
16 weeks
Title
Absolute and relative change in microalbumin/creatinine ratio
Time Frame
16 weeks
Title
Absolute and relative change in fat mass
Time Frame
16 weeks
Title
Absolute and relative change in body fat percentage
Time Frame
16 weeks
Title
Absolute and relative change in waist/hip ratio
Time Frame
16 weeks
Title
Absolute and relative change in visceral fat content
Time Frame
16 weeks
Title
Absolute and relative change in dietary protein
Time Frame
16 weeks
Title
Absolute and relative change in energy intake
Time Frame
16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has voluntarily signed and dated an informed consent form, approved by an Institutional Review Board/Independent Ethics Committee, and provided Health Insurance Portability and Accountability Act authorization (HIPAA) or other privacy authorization prior to any participation in study. Subject states that he/she had type 2 diabetes, as evidenced by use of anti-hyperglycemic medication or managed on lifestyle intervention only with A1C >7% Subject is between 30 and 80 years of age. Subject on stable dose of antihyperglycemic medications for the past 3 months or lifestyle intervention Subject is a male or a non-pregnant, non-lactating female, at least 6 weeks postpartum prior to screening visit. A urine pregnancy test is required for all female subjects unless she is not of childbearing potential, defined as postmenopausal for at least one year prior to screening visit or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy). If a female is of childbearing potential, she is practicing one of the following methods of birth control (and continued through the duration of the study): Condoms, sponge, diaphragm or intrauterine device; Oral or parenteral contraceptives for 3 months prior to screening visit; Vasectomized partner; Total abstinence from sexual intercourse. Subject's BMI is > 25 kg/m2. Subject has A1C between 7-10% If on a chronic medication such as anti-hypertensive, lipid-lowering, thyroid medication or hormone therapy, subject has been on stable dose for at least three months prior to screening visit. These medications will not be changed during intervention unless it is mandatory. Exclusion Criteria: Subjects using exogenous insulin since insulin titration may impact the primary endpoint. Subject states that he/she had a history of diabetic ketoacidosis. Subject is pregnant or lactating. Subject uses corticosteroid treatment with the exception of inhaled or topical steroids in the last 3 months; or antibiotics within the last 3 weeks prior to the screening visit. Subject states that he/she had an active malignancy (excluding the following dermal malignancies: basal cell carcinoma, squamous cell carcinoma, carcinoma in-situ of the cervix). Subject states that he/she has had a recent cardiovascular event (e.g., myocardial infarction, stroke) ≤ six months prior to screening visit; or stated history of congestive heart failure. Subject states that he/she has had end stage organ failure (such as end stage renal disease) or had status post organ transplant. Subject states that he/she has had a history of renal disease (Creatinine >1.5mg/dL or GFR <60 mL/min/1.73 m2). Subject states that he/she has had current hepatic disease. Subject has history of gastroparesis. Subject states that he/she has had a chronic, contagious, infectious disease Subject states that he/she has had clotting or bleeding disorders. Subject is known to be allergic or intolerant to any ingredient found in the study products. Subject is known to have a history of special nutritional need requiring special diet. Subject is currently participating in any weight loss program. Subject has used meal replacements during the 3 months prior to the start of the study. Subject has history of bariatric surgery. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Osama Hamdy, MD, PhD
Organizational Affiliation
Joslin Diabetes Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Joslin Diabetes Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
29626933
Citation
Mottalib A, Salsberg V, Mohd-Yusof BN, Mohamed W, Carolan P, Pober DM, Mitri J, Hamdy O. Effects of nutrition therapy on HbA1c and cardiovascular disease risk factors in overweight and obese patients with type 2 diabetes. Nutr J. 2018 Apr 7;17(1):42. doi: 10.1186/s12937-018-0351-0.
Results Reference
derived

Learn more about this trial

The Effect of 3 Different Models of MNT on DM Control in Overweight Patients With T2DM

We'll reach out to this number within 24 hrs