PDM: Prediabetes (2013)

PDM: Prediabetes (2013)

• Intervention
  In individuals with prediabetes, what is the impact of MNT on anthropometric outcomes (WC, WHR)?

  • Conclusion

    Most studies reported that medical nutrition therapy (MNT) significantly reduced waist circumference by 3.8cm to 5.9cm in individuals with prediabetes.

    Of two studies reporting waist-to-hip ratio, both reported no significant effect of MNT.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of MNT on anthropometric outcomes (WC, WHR)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn E, Feskens EJ, Jansen EH, Mensink M, Saris WH, de Bruin TW, Blaak EE. Improvements in glucose tolerance and insulin sensitivity after lifestyle intervention are related to changes in serum fatty acid profile and desaturase activities: The SLIM study. Diabetologia. 2006; 49 (10): 2,392-2,401.
      • Dyson PA, Hammers MS, Morris RJ, Holman RR, Turner RC, on behalf of the Fasting Hyperglycaemia Study Group. The Fasting Hyperglycaemia Study: II. Randomized controlled trial of reinforced healthy-living advice in subjects with increased but not diabetic fasting plasma glucose. Metabolism, 1997; 46 (12) Suppl 1: 50-55.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Katula JA, Vitolins MZ, Rosenberger EL, Blackwell CS, Morgan TM, Lawlor MS, Goff DC Jr. One-year results of a community-based translation of the Diabetes Prevention Program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project. Diabetes Care. 2011; 34(7): 1,451-1,457.
      • Oldroyd JC, Unwin NC, White M, Imrie K, Mathers JC, Alberti KGMM. Randomized controlled trial evaluating the effectiveness of behavioral interventions to modify cardiovascular risk factors in men and women with impaired glucose tolerance: Outcomes at six months. Diabetes Res Clin Pract. 2001; 52 (1): 29-43.
  • Search Plan and Results: PDM: Medical Nutrition Therapy and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of MNT on blood pressure?

  • Conclusion

    Research regarding the impact of medical nutrition therapy on systolic blood pressure reported mixed results. However, the majority of research reported no significant change on diastolic blood pressure in individuals with prediabetes.

    Additional intervention studies are needed regarding the effect of medical nutrition therapy on blood pressure in individuals with prediabetes.

     

     

     

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of MNT on blood pressure?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dyson PA, Hammers MS, Morris RJ, Holman RR, Turner RC, on behalf of the Fasting Hyperglycaemia Study Group. The Fasting Hyperglycaemia Study: II. Randomized controlled trial of reinforced healthy-living advice in subjects with increased but not diabetic fasting plasma glucose. Metabolism, 1997; 46 (12) Suppl 1: 50-55.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Oldroyd JC, Unwin NC, White M, Imrie K, Mathers JC, Alberti KGMM. Randomized controlled trial evaluating the effectiveness of behavioral interventions to modify cardiovascular risk factors in men and women with impaired glucose tolerance: Outcomes at six months. Diabetes Res Clin Pract. 2001; 52 (1): 29-43.
  • Search Plan and Results: PDM: Medical Nutrition Therapy and Prediabetes 2012
     
• Basic Research
  In individuals with prediabetes, what is the impact of MNT on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, 2-hour post prandial blood glucose, A1C)?

  • Conclusion

    Most studies reported that medical nutrition therapy (MNT) resulted in a significant decrease in fasting blood glucose of two mg to nine mg per dL (0.1mmol to 0.5mmol per L) and in two-hour post prandial blood glucose of nine mg to 16.2mg per dL (0.5mmol to 0.9mmol per L).

    Of four studies (five publications) reporting A1C values, all reported no significant effect of MNT.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of MNT on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, 2-hour post prandial blood glucose, A1C)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn E, Feskens EJ, Jansen EH, Mensink M, Saris WH, de Bruin TW, Blaak EE. Improvements in glucose tolerance and insulin sensitivity after lifestyle intervention are related to changes in serum fatty acid profile and desaturase activities: The SLIM study. Diabetologia. 2006; 49 (10): 2,392-2,401.
      • Dyson PA, Hammers MS, Morris RJ, Holman RR, Turner RC, on behalf of the Fasting Hyperglycaemia Study Group. The Fasting Hyperglycaemia Study: II. Randomized controlled trial of reinforced healthy-living advice in subjects with increased but not diabetic fasting plasma glucose. Metabolism, 1997; 46 (12) Suppl 1: 50-55.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Katula JA, Vitolins MZ, Rosenberger EL, Blackwell CS, Morgan TM, Lawlor MS, Goff DC Jr. One-year results of a community-based translation of the Diabetes Prevention Program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project. Diabetes Care. 2011; 34(7): 1,451-1,457.
      • Oldroyd JC, Unwin NC, White M, Imrie K, Mathers JC, Alberti KGMM. Randomized controlled trial evaluating the effectiveness of behavioral interventions to modify cardiovascular risk factors in men and women with impaired glucose tolerance: Outcomes at six months. Diabetes Res Clin Pract. 2001; 52 (1): 29-43.
  • Search Plan and Results: PDM: Medical Nutrition Therapy and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of MNT on lipid outcomes (TG, HDL)?

  • Conclusion

    Most studies reported no significant impact of medical nutrition therapy (MNT) on serum triglycerides in individuals with prediabetes. All studies reported no significant change in HDL-cholesterol.

    Additional intervention studies are needed regarding the effect of medical nutrition therapy on lipid outcomes (triglycerides and HDL-cholesterol) in individuals with prediabetes with elevated triglycerides or low HDL-cholesterol.

     

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of MNT on lipid outcomes (TG, HDL)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dyson PA, Hammers MS, Morris RJ, Holman RR, Turner RC, on behalf of the Fasting Hyperglycaemia Study Group. The Fasting Hyperglycaemia Study: II. Randomized controlled trial of reinforced healthy-living advice in subjects with increased but not diabetic fasting plasma glucose. Metabolism, 1997; 46 (12) Suppl 1: 50-55.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Oldroyd JC, Unwin NC, White M, Imrie K, Mathers JC, Alberti KGMM. Randomized controlled trial evaluating the effectiveness of behavioral interventions to modify cardiovascular risk factors in men and women with impaired glucose tolerance: Outcomes at six months. Diabetes Res Clin Pract. 2001; 52 (1): 29-43.
  • Search Plan and Results: PDM: Medical Nutrition Therapy and Prediabetes 2012