Diabetes Mellitus, Type 1 Clinical Trial
Official title:
Effect of Structured Education in Advanced Carbohydrate Counting or Healthy Food Choices With Low Glycemic Index in Type 1 Diabetes
Type 1 diabetes (T1DM) is a chronic disease that affects approximately 10% of all diabetes
patients in the world. Diabetes a serious disease in which life expectancy is reduced,
largely due to increased mortality from kidney disease and cardiovascular (CVD) disease. Poor
glycemic control also results in eye and nerve damage, and psychosocial stress. Good
metabolic control, e.g. normalized hemoglobin levels (HbA1c) and normal blood lipids, reduces
the risk of eye, kidney, nerve, and vascular damage. Proper nutrition can normalize blood
sugar levels, improve blood lipids and prolong life in people with diabetes, according to
Swedish Council on Health Technology Assessment (SBU).
Dietary treatment is therefore seen as pivotal in the treatment of diabetes. This project
aims to evaluate two methods of structured training in patients with type 1 diabetes:
1. A structured education in carbohydrate counting, a course inspired by the DAFNE program
(Dose Adjustment For Normal Eating)
2. A new, structured education for heart healthy food choices and low glycemic index in
type 1 diabetes. The education is called "My Wellness-LADDER" (Lifelong Adult Diet &
Diabetes Education Resource) and it is specifically designed to provide high long-term
adherence through improved empowerment and transformative life style change.
The methods are compared with regular routine (control group).
This is a randomized controlled trial with three intervention groups 1) Healthy food choices
with a low glycemic index, 2) carbohydrate counting, and 3) regular routine. Follow‐up period
is 1 year. Eight Swedish specialist clinics are participating and 24 patients at each clinic
are to be enrolled.
The hypotheses is that structured group education on heart healthy food choices and low
glycemic index provide the same improvement in glycemic control and quality of life as
advanced carbohydrate counting in T1DM, as compared to regular routine. An additional
hypotheses is that structured education on healthy food choices and low glycemic index leads
to larger CVD risk factor reductions in T1DM compared to carbohydrate counting and regular
routine and that structured education on healthy food choices and low glycemic index lead to
more heart healthy food choices in T1DM compared to carbohydrate counting and regular
routine. Lastly, the hypotheses is that structured education on healthy food choices and low
glycemic index lead is more cost effective in T1DM compared to carbohydrate counting and
regular routine.
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