DASH4D diet for glycemic control and glucose variability in type 2 diabetes: a randomized crossover trial.

The Dietary Approaches to Stop Hypertension (DASH) diet is rich in foods (fruits, vegetables, whole grains) that may reduce hyperglycemia and glycemic variability. In this randomized crossover feeding trial, 89 participants with type 2 diabetes were fed four isocaloric diets in a random order: the DASH4D diet (a DASH-style diet tailored for diabetes) or a comparison (typical American) diet, each with higher (3,700 mg day at 2,000 kcal) or lower (1,500 mg day at 2,000 kcal) sodium. Each feeding period lasted 5 weeks.

Dietary Patterns, Sodium Reduction, and Blood Pressure in Type 2 Diabetes: The DASH4D Randomized Clinical Trial.

Importance: People with type 2 diabetes and hypertension are at high risk for blood pressure-related cardiovascular events. Few trials have tested the blood pressure-lowering effects of dietary interventions other than weight loss in this population.

Objective: To determine the effects of dietary patterns and sodium reduction on blood pressure in adults with type 2 diabetes.

Effects of Time-Restricted Eating on Actigraphy-Derived Sleep Parameters: Post-Hoc Analysis of a Randomized, Isocaloric Feeding Study.

Study Objectives: Time-restricted eating (TRE) is a novel dietary intervention targeting weight loss and cardiometabolic risk factors. The impact of TRE on sleep patterns remains under-explored.

Methods: This was a post-hoc analysis of a parallel-arm, controlled feeding trial in 41 adults with obesity and prediabetes/diabetes, randomized to TRE (8am-6pm) or usual eating pattern (UEP; 8am-12am) for 12 weeks.

Design of the Continuous Glucose Monitoring (CGM) Study in the Dietary Approaches to Stop Hypertension for Diabetes Trial (DASH4D-CGM).

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for adults with diabetes. However, the effects of the DASH diet on glucose control and variability have not been thoroughly investigated.

Study Aim: To study the effects of a modified DASH diet on glycemic control and glucose variability assessed by continuous glucose monitoring (CGM) in individuals with hypertension and type 2 diabetes.

A National Physician Survey Examining Switching From Sulfonylureas or Insulin to Newer Diabetes Medications.

This study was a national survey of U.S. physicians in general medicine, geriatrics, or endocrinology who were asked what medication change they would make for adults with type 2 diabetes taking sulfonylureas or insulin with an A1C below their individualized goal.

Within and post-trial effects of an intensive lifestyle intervention on kidney disease in adults with overweight or obesity and type 2 diabetes mellitus: a secondary analysis of the Look AHEAD clinical trial.

Introduction: The Look AHEAD randomized clinical trial reported that an 8-year intensive lifestyle intervention (ILI) compared with diabetes support and education (DSE) in adults aged 45-76 years with type 2 diabetes and overweight/obesity delayed kidney disease progression. Here, we report long-term post-intervention follow-up for the trial's secondary outcome of kidney disease.

Research Design And Methods: We examined effects of ILI (n=2570) versus DSE (n=2575) on decline in estimated glomerular filtration rate (eGFR) to <45 mL/min/1.

Diabetic Kidney Disease Prevention Care Model Development.

More than one-third of people with diabetes develop diabetic kidney disease (DKD), which substantially increases risks of kidney failure, cardiovascular disease (CVD), hypoglycemia, death, and other adverse health outcomes. A multifaceted approach incorporating self-management education, lifestyle optimization, pharmacological intervention, CVD prevention, and psychosocial support is crucial to mitigate the onset and progression of DKD. The American Diabetes Association convened an expert panel to develop the DKD Prevention Model presented herein.

Assessment and prevention of hypoglycaemia in primary care among U.S. Veterans: a mixed methods study.

Background: Hypoglycaemia from diabetes treatment causes morbidity and lower quality of life, and prevention should be routinely addressed in clinical visits.

Methods: This mixed methods study evaluated how primary care providers (PCPs) assess for and prevent hypoglycaemia by analyzing audio-recorded visits from five Veterans Affairs medical centres in the US. Two investigators independently coded visit dialogue to classify discussions of hypoglycaemia history, anticipatory guidance, and adjustments to hypoglycaemia-causing medications according to diabetes guidelines.

Association of Lifestyle Intervention With Risk for Cardiovascular Events Differs by Level of Glycated Hemoglobin.

Purpose: We reevaluated the Action for Health in Diabetes (Look AHEAD) intensive lifestyle intervention (ILI) to assess whether the effect of ILI on cardiovascular disease (CVD) prevention differed by baseline glycated hemoglobin (HbA1c).

Methods: Look AHEAD randomized 5145 adults, aged 45 to 76 years with type 2 diabetes and overweight/obesity to ILI or a diabetes support and education (DSE) control group for a median of 9.6 years.

A National Survey of Physicians' Views on the Importance and Implementation of Deintensifying Diabetes Medications.

Background: Guidelines recommend deintensifying hypoglycemia-causing medications for older adults with diabetes whose hemoglobin A1c is below their individualized target, but this rarely occurs in practice.

Objective: To understand physicians' decision-making around deintensifying diabetes treatment.

Design: National physician survey.

Precision medicine in type 2 diabetes: A systematic review of treatment effect heterogeneity for GLP1-receptor agonists and SGLT2-inhibitors.

Background: A precision medicine approach in type 2 diabetes requires identification of clinical and biological features that are reproducibly associated with differences in clinical outcomes with specific anti-hyperglycaemic therapies. Robust evidence of such treatment effect heterogeneity could support more individualized clinical decisions on optimal type 2 diabetes therapy.

Methods: We performed a pre-registered systematic review of meta-analysis studies, randomized control trials, and observational studies evaluating clinical and biological features associated with heterogenous treatment effects for SGLT2-inhibitor and GLP1-receptor agonist therapies, considering glycaemic, cardiovascular, and renal outcomes.

Design and Implementation of a Time-Restricted Eating Intervention in a Randomized, Controlled Eating Study.

The efficacy of time-restricted eating for weight loss has not been established, as prior studies were limited by a lack of controlled isocaloric designs. This study describes the design and implementation of interventions in a controlled eating study evaluating time-restricted eating. We designed a randomized, controlled, parallel-arm eating study comparing time-restricted eating (TRE) to a usual eating pattern (UEP) for the primary outcome of weight change.

A National Physician Survey of Deintensifying Diabetes Medications for Older Adults With Type 2 Diabetes.

Objective: To determine physicians' approach to deintensifying (reducing/stopping) or switching hypoglycemia-causing medications for older adults with type 2 diabetes.

Research Design And Methods: In this national survey, U.S.

An Examination of Whether Diabetes Control and Treatments Are Associated With Change in Frailty Index Across 8 Years: An Ancillary Exploratory Study From the Action for Health in Diabetes (Look AHEAD) Trial.

Objective: The aim of this study was to describe cross-sectional and longitudinal associations between glycated hemoglobin (HbA1c) levels and strategies to control type 2 diabetes with baseline levels and 8-year changes in a deficit accumulation frailty index (FI), a commonly used marker of biological aging.

Research Design And Methods: We conducted exploratory analyses from 4,169 participants, aged 45-76 years, who were followed in the Action for Health in Diabetes (Look AHEAD) randomized controlled clinical trial, pooling data across intervention groups. We related baseline and 8-year levels of HbA1c with FI scores using analyses of variance and covariance.

A Qualitative Study of Perspectives of Older Adults on Deintensifying Diabetes Medications.

Background: While many older adults with type 2 diabetes have tight glycemic control beyond guideline-recommended targets, deintensifying (stopping or dose-reducing) diabetes medications rarely occurs.

Objective: To explore the perspectives of older adults with type 2 diabetes around deintensifying diabetes medications.

Design: This qualitative study used individual semi-structured interviews, which included three clinical scenarios where deintensification may be indicated.