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Trial registered on ANZCTR
Registration number
ACTRN12612000369820
Ethics application status
Approved
Date submitted
15/03/2012
Date registered
30/03/2012
Date last updated
14/08/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Role of very low carbohydrate diets for type 2 diabetes- Diabetes management
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Scientific title
Long-term (2 years) effects of a very low carbohydrate, low saturated fat diet compared to a conventional high carbohydrate, low fat diet on glycemic control and cardiovascular disease risk in overweight and obese patients with type 2 diabetes.
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Secondary ID [1]
280093
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 diabetes
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Condition category
Condition code
Metabolic and Endocrine
286195
286195
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0
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Diabetes
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Diet and Nutrition
286397
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0
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Very low carbohydrate, low saturated fat diet (N=75: 14% carbohydrate [<50 g carbohydrate/day], 28% protein, 58% fat). The overall duration of the study is 2 years (104 weeks).
The dietary pattern will be translated and consumed daily for the duration of the study in the form a dietary plan that incorporates freely available foods from the current food supply. This will include a breakfast, lunch and evening meal and snacks that will reflect the dietary composition described.
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Intervention code [1]
284366
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Lifestyle
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Comparator / control treatment
High carbohydrate, low saturated fat diet (N=75: 53% carbohydrate, 17%, protein, 30% fat). The overall duration of the study is 2 years (104 weeks).
The dietary pattern will be translated and consumed daily for the duration of the study in the form a dietary plan that incorporates freely available foods from the current food supply. This will include a breakfast, lunch and evening meal and snacks that will reflect the dietary composition described.
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Control group
Active
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Outcomes
Primary outcome [1]
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Glycated haemoglobin measured at a certified clinical laboratory using standard assay kits.
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Assessment method [1]
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Timepoint [1]
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Weeks 0, 24, 52 and 104
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Primary outcome [2]
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flow mediated dilatation measured using ultrasound to assess the diameter change in the brachial artery in response to increased blood flow induced by 5 minutes of forearm occlusion with an inflated blood pressure cuff placed around the forearm.
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Assessment method [2]
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Timepoint [2]
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Weeks 0, 24, 52 and 104
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Secondary outcome [1]
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blood lipids measured using a clinical auto-anaylser and standard assay kits.
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Assessment method [1]
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Timepoint [1]
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Weeks 0, 24, 52 and 104
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Secondary outcome [2]
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body composition measured using dual x-ray absorptometry.
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Assessment method [2]
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Timepoint [2]
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Weeks 0, 24, 52 and 104
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Secondary outcome [3]
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Body weight measured using calibrated clinic weighting scales
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Assessment method [3]
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Timepoint [3]
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Week 0, 2, 4, 6, 8, 10, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 74, 78, 82, 86, 92, 96, 100, 104
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Secondary outcome [4]
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Fasting plasma insulin measured using a standard Elisa Kit
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Assessment method [4]
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Timepoint [4]
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Week 0, 24, 52 and 104
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Secondary outcome [5]
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Medication changes document by medication name and dosage changes
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Assessment method [5]
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Timepoint [5]
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Week 0, 2, 4, 6, 8, 10, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 74, 78, 82, 86, 92, 96, 100, 104
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Secondary outcome [6]
304164
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Blood Pressure measure using automated oscillation
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Assessment method [6]
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Timepoint [6]
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Week 0, 2, 4, 6, 8, 10, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 74, 78, 82, 86, 92, 96, 100, 104
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Secondary outcome [7]
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Glycemic variability and diurnal patterning using 3-day continuous glucose monitoring
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Assessment method [7]
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Timepoint [7]
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Week 0, 24, 52 and 104
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Secondary outcome [8]
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Plasma folate, B12 and Homocysteine, Vitamin D measured at a certified clinical laboratory using standard assay kits.
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Assessment method [8]
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Timepoint [8]
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Week 0, 24, 52 and 104
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Secondary outcome [9]
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Serum Beta crosslaps and parathyroid hormone measured at a certified clinical laboratory using standard assay kits.
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Assessment method [9]
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Timepoint [9]
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Week 0, 24, 52 and 104
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Secondary outcome [10]
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Fasting plasma creatinine measured using a clinical auto-anaylser and standard assay kits.
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Assessment method [10]
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Timepoint [10]
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Weeks 0, 24, 52 and 104
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Secondary outcome [11]
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Fasting plasma ketones measured using a clinical auto-anaylser and standard assay kits.
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Assessment method [11]
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Timepoint [11]
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Week 0, 2, 4, 6, 8, 10, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 74, 78, 82, 86, 92, 96, 100, 104
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Secondary outcome [12]
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Inflammatory markers of human cardiovascular disease risk markers using standard multiplex assay kits
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Assessment method [12]
304170
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Timepoint [12]
304170
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Weeks 0, 24, 52 and 104
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Secondary outcome [13]
304171
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Human tissue telomere length using quantitative PCR (qPCR)
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Assessment method [13]
304171
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Timepoint [13]
304171
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Weeks 0, 24, 52 and 104
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Secondary outcome [14]
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Plasma nitrates/nitrites measured using a clinical auto-anaylser and standard assay kits.
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Assessment method [14]
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Timepoint [14]
304172
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Weeks 0, 24, 52 and 104
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Secondary outcome [15]
304173
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Urinary albumin, urea, calcium and creatinine measured at a certified clinical laboratory using standard assay kits.
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Assessment method [15]
304173
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Timepoint [15]
304173
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Weeks 0, 24, 52 and 104
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Secondary outcome [16]
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Mood state, sleep quality, food cravings, and mental wellbeing using a series of validated assessment questionnaires.
Mood Questionnaires: Beck Depression Inventory, Spielberger Strait-trait anxiety Inventory, Profile of Mood States, Diabetes 39 – Quality of Life Questionnaire, Problem Areas in Diabetes Questionnaire, Pittsburgh Sleep Quality Index, Food Cravings Inventory, Eating Style Scale.
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Assessment method [16]
304174
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Timepoint [16]
304174
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Week 0, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 74, 78, 82, 86, 92, 96, 100, 104
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Secondary outcome [17]
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Physical activity measured using 7-day accelerometery and the international physical activity questionnaire (Ipaq)
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Assessment method [17]
304175
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Timepoint [17]
304175
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Week 0, 24, 52 and 104
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Secondary outcome [18]
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Appetite using a validated 7-day appetite history and record log
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Assessment method [18]
304176
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Timepoint [18]
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Week 0, 4,16, 24 and 52
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Secondary outcome [19]
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Cognitive Function assessed using a series of validated paper and computer based assessments.
The list of cognitive tasks are: Odd man out reaction time, Word memory, Operation span, 2 choice reaction time, Number memory scanning, Colour stroop task, Digit symbol substitution, Word endings and Letter sets.
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Assessment method [19]
304177
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Timepoint [19]
304177
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Weeks 0, 24, 52 and 104
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Secondary outcome [20]
304178
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Food intake using weighed food records and diet histories
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Assessment method [20]
304178
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Timepoint [20]
304178
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Week 0, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 74, 78, 82, 86, 92, 96, 100, 104
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Secondary outcome [21]
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Breathe Volatile Compounds in the exhaled breath by mass spectrometry
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Assessment method [21]
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Timepoint [21]
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Week 0, 12 and 52
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Eligibility
Key inclusion criteria
Male or female
Age between 35-65 years
Body Mass Index not greater than 40 or less than 26 Have type 2 diabetes (HbA1c 7.0-9.0% or previously diagnosed and controlled with medication)
Not have type 1 diabetes
Participants must understand the procedures involved and agree to participate in the study by giving full informed, written consent
No abnormality of clinical significance on medical history
If female,not pregnant or breast feeding
No history of coronary artery disease or cardiac (heart) abnormalities
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Minimum age
35
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Body Mass Index greater than 40 or less than 26
Not have type 2 diabetes
Lactose Intolerant
Have proteinuria, a malignancy, abnormal liver function, any significant endocrinopathy, or a history of metabolic disease such as liver, kidney, cardiovascular, respiratory or gastrointestinal disease, cardiac (heart) abnormalities or are pregnant or lactating
Have high uncontrolled hypertension (resting recumbent blood pressure greater than 160/100 mmHg)
Have depression
Have a musculoskeletal injury, joint or peripheral vascular disease sufficient to impede exercise (such as hip arthritis, foot, ankle problems or pain)
Have severe exercise-induced asthma
History of smoking during 6 months prior to study
History of heavy alcohol consumption (more than 5 Standard drinks/day)
Volunteer unable to limit alcohol consumption for study duration
Participated in regular aerobic or resistance exercise program (greater than two 30-min sessions of moderate/vigorous aerobic exercise per week or greater than 1 moderate intensity resistance exercise session per week) during the 6 months prior to study
Currently on a weight reducing diet or have an eating disorder
Unwilling to be randomized to either experimental group
Extended absences due to travel or other commitments
Unable to comprehend or cope with study requirements
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
5/03/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
150
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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Level 1
16 Marcus Clarke Street
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Commonwealth Scientific Industrial Research Organisation - Food and Nutritional Sciences
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Address
Gate 13
Kintore Avenue
Adelaide SA 5000
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
To evaluate, in overweight/obese patients with type 2 diabetes mellitus the chronic effects (24 months) of an energy restricted, very low carbohydrate (<50 g/day), low saturated fat (<10%) diet compared to an isocaloric high unrefined carbohydrate, low fat diet on: Primary outcomes: glycemic control, cardiovascular disease risk factors and endothelial function Secondary outcomes: weight loss, body composition, appetite, diet acceptance, renal/bone health.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Grant Brinkworth
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Address
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Commonwealth Scientific Industrial Research Organisation
Gate 13 Kintore Avenue Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 83038830
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Anne McGuffin
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Address
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Gate 13
Kintore Avenue
Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 83038988
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Grant Brinkworth
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Address
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Gate 13
Kintore Avenue
Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 8303 8830
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Comparison of low- and high-carbohydrate diets for type 2 diabetes management: A randomized trial.
2015
https://dx.doi.org/10.3945/ajcn.115.112581
Embase
Long-Term Effects of a Very Low Carbohydrate Compared With a High Carbohydrate Diet on Renal Function in Individuals With Type 2 Diabetes: A Randomized Trial.
2015
https://dx.doi.org/10.1097/MD.0000000000002181
Embase
Effects of an energy-restricted low-carbohydrate, high unsaturated fat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial.
2018
https://dx.doi.org/10.1111/dom.13164
Embase
Nutritional adequacy of very low- and high-carbohydrate, low saturated fat diets in adults with type 2 diabetes: A secondary analysis of a 2-year randomised controlled trial.
2020
https://dx.doi.org/10.1016/j.diabres.2020.108501
Embase
Effects of very low-carbohydrate vs. high-carbohydrate weight loss diets on psychological health in adults with obesity and type 2 diabetes: a 2-year randomized controlled trial.
2021
https://dx.doi.org/10.1007/s00394-021-02587-z
N.B. These documents automatically identified may not have been verified by the study sponsor.
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