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Trial registered on ANZCTR
Registration number
ACTRN12622000253707
Ethics application status
Approved
Date submitted
19/01/2022
Date registered
11/02/2022
Date last updated
23/06/2024
Date data sharing statement initially provided
11/02/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Optimising daily carbohydrate intake for blood glucose management in people with type 2 diabetes; finding the sweet spot
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Scientific title
Optimal carbohydrate dose to achieve glycaemic targets in people with Type 2 diabetes following a low carbohydrate diet; a proof a concept study
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Secondary ID [1]
306030
0
nil known
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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
324663
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Condition category
Condition code
Metabolic and Endocrine
322113
322113
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This randomised crossover control trial will have a usual dietary intake period of 1-weeks followed by three 1-week intervention protocols assigned in random order; 50g per day total carbohydrate intake, 90g per day total carbohydrate intake and 130g per day total carbohydrate intake. Protein intake will remain constant and fat intake will be adjusted accordingly to ensure each arm is isoenergetic. There will be at least 1 week washout period between conditions.
Participants will receive a recipe book and a $600 grocery voucher. Sample meal plans will be provided and individual diets tailored during a 1-hour consultation with a dietitian (either face-to face or via telehealth) at the start of each intervention. A weekly scheduled e-mail/phone call check in will be available for participants, as well as unlimited email contact with the study dietitian as needed. Scales will be provided to assist participants accurately measure food and beverage quantity.
To control for weight-loss, the Mifflin equation will be used to estimate the daily energy requirement for each participant. Weight will be recorded at baseline and again following each 2-week intervention period. Caloric intake will be adjusted as needed prior to commencing the next intervention.
The app Easy Diet Diary will be used to self-report daily intake as an adherence measure, along with weekly check-ins with the dietitian
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Intervention code [1]
322427
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Lifestyle
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Intervention code [2]
322428
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Behaviour
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Intervention code [3]
322733
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Treatment: Other
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Comparator / control treatment
The participants usual diet will be the control for each participant.
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Control group
Active
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Outcomes
Primary outcome [1]
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Glucose time in range (3.9-10 mmol/L) assessed using a continuous glucose monitor
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Assessment method [1]
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Timepoint [1]
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Monitored continuously during each 2-week intervention period and control period
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Secondary outcome [1]
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Changes in fasting blood glucose concentration assessed using a continuous glucose monitor
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Assessment method [1]
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Timepoint [1]
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Monitored continuously during each 1-week intervention/control period
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Secondary outcome [2]
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Changes in mean 24-h glucose area under the curve using a continuous glucose monitor
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Assessment method [2]
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Timepoint [2]
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Monitored continuously during each 1-week intervention/control period
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Secondary outcome [3]
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Changes in glucose time above range (> 10.0 mmol/L) using a continuous glucose monitor
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Assessment method [3]
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Timepoint [3]
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Monitored continuously during each 1-week intervention/control period
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Secondary outcome [4]
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Changes in incremental area under the glucose curve assessed using a continuous glucose monitor
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Assessment method [4]
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Timepoint [4]
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Monitored continuously during each 1-week intervention/control period
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Secondary outcome [5]
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pro-insulin: C-peptide ratio assessed using intravenous blood samples taken pre- and post-a mixed meal tolerance test
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Assessment method [5]
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Timepoint [5]
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Monitored continuously during each 1-week intervention/control period
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Secondary outcome [6]
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Changes in blood lipids including triglycerides and cholesterol
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Assessment method [6]
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Timepoint [6]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [7]
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Disposition Index (DI) assessed using intravenous blood samples taken pre- and post-a mixed meal tolerance test
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Assessment method [7]
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Timepoint [7]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [8]
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metabolic markers including fasting glucose, fasting insulin and apo-B assessed using intravenous blood samples
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Assessment method [8]
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Timepoint [8]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [9]
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nutritional markers including prealbumin, IGF-1 and micronutrients (vitamins/minerals) assessed using intravenous blood samples taken pre- and post-a mixed meal tolerance test
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Assessment method [9]
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Timepoint [9]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [10]
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inflammatory markers such as CRP and TNF-a assessed using intravenous blood samples taken pre- and post-a mixed meal tolerance test
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Assessment method [10]
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Timepoint [10]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [11]
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Physical activity (including steps, light activity, standing and sedentary time) will be monitored using an ActivPAL inclinometer attached to the thigh using adhesive tape
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Assessment method [11]
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Timepoint [11]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [12]
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Insulin sensitivity assessed using a venous blood sample,
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Assessment method [12]
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Timepoint [12]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [13]
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Glucose variability assessed using a continuous glucose monitor
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Assessment method [13]
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Timepoint [13]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [14]
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Dietary intake using the Easy Diet Diary app
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Assessment method [14]
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Timepoint [14]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [15]
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Diet satisfaction assessed using the Diet Satisfaction 45 survey (Ello-Martin, 2006)
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Assessment method [15]
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Timepoint [15]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [16]
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Weight assessed using electronic standing scales
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Assessment method [16]
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Timepoint [16]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [17]
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Waist circumference assessed using a tape measure
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Assessment method [17]
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Timepoint [17]
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On day 1 and 7 of each 1-week intervention period
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Secondary outcome [18]
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Diet satisfaction assessed using audio-recorded, 30-minute, semi-structured qualitative interviews
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Assessment method [18]
405636
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Timepoint [18]
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At the conclusion of the study period (6 weeks from baseline minimum)
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Secondary outcome [19]
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5-point Likert scale Theory of Planned Behaviour (TPB) survey
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Assessment method [19]
405639
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Timepoint [19]
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On day 1 and 7 of each 1-week intervention period
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Eligibility
Key inclusion criteria
Aged between 30 and 70 years
Formal diagnosis of type 2 diabetes
Current HbA1c 6.5-9%
Stable medication and weight for previous 3 months
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Minimum age
30
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Non-English speakers
severe kidney or liver diseases
undergoing treatment for cancer
Previous bariatric surgery
Insulin or sulfonylureas
Pregnancy and breastfeeding
Food allergies or aversions that may prevent participation, to be evaluated on a case-by-case basis
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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)
Allocation is concealed using sealed envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation table generated by computer program
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Data will be analysed using a linear mixed model.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/10/2022
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Actual
24/10/2022
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Date of last participant enrolment
Anticipated
1/07/2024
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Actual
1/11/2023
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Date of last data collection
Anticipated
31/08/2024
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Actual
15/12/2023
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Sample size
Target
29
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Accrual to date
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Final
19
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Funding & Sponsors
Funding source category [1]
310369
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University
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Name [1]
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University of Wollongong
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Address [1]
310369
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Illawarra Health and Medical Institute, Building 32 University of Wollongong, Northfields Avenue Wollongong NSW 2500
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Country [1]
310369
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Australia
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Primary sponsor type
University
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Name
University of Wollongong
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Address
Illawarra Health and Medical Institute, Building 32 University of Wollongong, Northfields Avenue Wollongong NSW 2500
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Country
Australia
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Secondary sponsor category [1]
311507
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None
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Name [1]
311507
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not applicable
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Address [1]
311507
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not applicable
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Country [1]
311507
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310022
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Joint University of Wollongong and Illawarra Shoalhaven Local Health District Health and Medical Human Research Ethics Committee
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Ethics committee address [1]
310022
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University of Wollongong, Northfields Avenue Wollongong NSW 2500
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Ethics committee country [1]
310022
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Australia
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Date submitted for ethics approval [1]
310022
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07/12/2021
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Approval date [1]
310022
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06/09/2022
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Ethics approval number [1]
310022
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2021/413
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Summary
Brief summary
The aim of this study is to compare glycaemic control with 50, 90 and 130 g carbohydrates per day in people with type 2 diabetes and to test whether a 90g carbohydrate reduction is enough to improve time in range (3.9-10 mmol/L) and decrease time above range (>10 mmol/L) compared to the commonly used lower carbohydrate definitions of 50g and 130g carbohydrates per day for the management and treatment of T2D (hyperglycaemia) through diet.
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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 Monique Francois
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Address
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University of Wollongong, Northfields Avenue Wollongong, NSW 2500
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Country
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Australia
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Phone
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+61 2 4221 5136
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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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Katie Oetsch
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Address
116215
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University of Wollongong, Northfields Avenue Wollongong, NSW 2500
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Country
116215
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Australia
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Phone
116215
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+61 2 4221 5136
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Fax
116215
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Email
116215
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[email protected]
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Contact person for scientific queries
Name
116216
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Katie Oetsch
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Address
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University of Wollongong, Northfields Avenue Wollongong, NSW 2500
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Country
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Australia
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Phone
116216
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+61 2 4221 5136
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Fax
116216
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Email
116216
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
14407
Ethical approval
ethical approval is not yet available
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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