Evidence map›Paper›PMID 29435347›Full record

ArticleBMJ open diabetes research & care2017

Structured lifestyle intervention based on a trans-cultural diabetes-specific nutrition algorithm (tDNA) in individuals with type 2 diabetes: a randomized controlled trial.

Winnie S S Chee, Harvinder Kaur Gilcharan Singh, Osama Hamdy, Jeffrey I Mechanick, Verna K M Lee, Ankur Barua, Siti Zubaidah Mohd Ali, Zanariah Hussein

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open diabetes research & care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  4. A systematic review and meta-analysis of the effectiveness of meal replacements for weight loss.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Winnie S S CheeDepartment of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia.
Harvinder Kaur Gilcharan SinghDepartment of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia.
Osama HamdyDivision of Endocrinology, Diabetes and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, USA.
Jeffrey I MechanickDivision of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, USA.
Verna K M LeeDepartment of Family Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
Ankur BaruaDepartment of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
Siti Zubaidah Mohd AliDepartment of Non-Communicable Diseases, Klinik Kesihatan Seremban, Negeri Sembilan, Malaysia.
Zanariah HusseinDepartment of Medicine, Hospital Putrajaya, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTrans-cultural diabetes nutrition algorithm (tDNA) was created by international task force and culturally customized for Malaysian population. This study was designed to evaluate its effectiveness versus usual diabetes care in primary care settings. RESEARCH DESIGN AND

methodsWe randomized 230 patients with overweight/obesity, type 2 diabetes, and glycated hemoglobin (A1c) 7%-11% to receive usual care (UC) or UC with tDNA for 6 months. The tDNA intervention consisted of structured low-calorie meal plan, diabetes-specific meal replacements, and increased physical activity. Participants were counseled either through motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice through conventional counseling. All patients were followed for another 6 months after intervention.

resultsAt 6 months, A1c decreased significantly in tDNA-MI (-1.1±0.1%, p<0.001) and tDNA-CC (-0.5±0.1%, p=0.001) but not in UC (-0.2±0.1%, p=NS). Body weight decreased significantly in tDNA-MI (-6.9±1.3 kg, p<0.001) and tDNA-CC (-5.3±1.2 kg, p<0.001) but not in UC (-0.8±0.5 kg, p=NS). tDNA-MI patients had significantly lower fasting plasma glucose (tDNA-MI: -1.1±0.3 mmol/L, p<0.001; tDNA-CC: -0.6±0.3 mmol/L, p=NS; UC: 0.1±0.3 mmol/L, p=NS) and systolic blood pressure (tDNA-MI: -9±2 mm Hg, p<0.001; tDNA-CC: -9±2 mm Hg, p=0.001; UC: -1±2 mm Hg, p=NS). At 1 year, tDNA-MI patients maintained significant reduction in A1c (tDNA-MI: -0.5±0.2%, p=0.006 vs tDNA-CC: 0.1±0.2%, p=NS and UC: 0.02±0.01%, p=NS) and significant weight loss (tDNA-MI: -5.8±1.3 kg, p<0.001 vs tDNA-CC: -3.3±1.2 kg, p=NS and UC: 0.5±0.6 kg, p=NS).

conclusionsStructured lifestyle intervention through culturally adapted nutrition algorithm and motivational interviewing significantly improved diabetes control and body weight in primary care setting.

Indexed as

lifestyle interventionmetabolic controltype 2 diabetesweight loss

Identifiers

PMID29435347
PMCPMC5623265

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.