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Trial registered on ANZCTR
Registration number
ACTRN12606000490572
Ethics application status
Approved
Date submitted
25/09/2006
Date registered
28/11/2006
Date last updated
23/11/2021
Date data sharing statement initially provided
22/06/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Diabetes Excess Weight Loss (DEWL) Trial: High Protein vs Low Fat Diets
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Scientific title
Diabetes Excess Weight Loss (DEWL) Trial: High Protein vs Low Fat Diets
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Secondary ID [1]
304586
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Nil Known
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Universal Trial Number (UTN)
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Trial acronym
DEWL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetes
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Obesity
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Condition category
Condition code
Metabolic and Endocrine
1563
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0
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Diabetes
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Diet and Nutrition
1564
1564
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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
High protein diet versus a low fat diet:
Group 2 (Intervention) “High-Protein:Reduced-Carbohydrate”: Reduced carbohydrate (40% total energy) with a focus on whole grains, low glycaemic index foods, and high fibre (30g/day). The diet will also include increased protein (30% total energy) and moderate fat (30% total energy) with a focus on Monounsaturated Fatty Acids and Polyunsaturated Fatty Acids and no more than 10% being saturated fat, aiming for a reduction in total energy intake of 500kcal/day.
All subjects will take part in a 12-month group-based programme, attending fortnightly meetings with a dietitian for the first six months to facilitate weight loss and adherence to the specific dietary protocol. This will be followed by a less intensive 6-month period with monthly sessions. Subjects will then be asked to maintain their weight loss by adhering to the dietary protocol, but will have no further dietitian input for a further 12 months, apart from monthly weighs.
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Intervention code [1]
1376
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Lifestyle
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Comparator / control treatment
Group 1 (Control) Conventional- “Low-fat”: Subjects in this group will be prescribed an energy-restricted diet based on current recommended macronutrient composition. This will include 55-60% carbohydrate, with predominantly low glycaemic index, whole-grain foods with high fibre intake (30g/day), and minimal refined carbohydrates. The balance of the diet will be composed of 25-30% fat, with no more than 10% being saturated fat, and approximately 15% protein, aiming for a reduction in total energy intake of 500kcal/day.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in weight
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Assessment method [1]
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Timepoint [1]
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Measured at baseline, 6 months, 12 months and 24 months
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Primary outcome [2]
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Change in waist circumference
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Assessment method [2]
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Timepoint [2]
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Measured at baseline, 6 months, 12 months and 24 months
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Secondary outcome [1]
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Glycaemic control (serum HbA1c)
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Assessment method [1]
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Timepoint [1]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Secondary outcome [2]
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Systolic and diastolic blood pressure
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Assessment method [2]
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Timepoint [2]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Secondary outcome [3]
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Lipid profile (Total cholesterol, LDL, triglycerides, HDL)
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Assessment method [3]
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Timepoint [3]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Secondary outcome [4]
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Dietary adherence,
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Assessment method [4]
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Timepoint [4]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Secondary outcome [5]
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Body fatness (bio-impedance)
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Assessment method [5]
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Timepoint [5]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Secondary outcome [6]
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Renal function
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Assessment method [6]
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Timepoint [6]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Secondary outcome [7]
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Quality of life
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Assessment method [7]
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Timepoint [7]
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Outcome measures are assessed at baseline, 6 months, 12 months and 24 months.
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Eligibility
Key inclusion criteria
Overweight (BMI equal or greater than 27kg/m2) adults with established type 2 diabetes requiring oral antidiabetic agents and/or insulin, or are diet-controlled and meet the WHO criteria for diabetes.
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Minimum age
30
Years
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Maximum age
75
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
Current or recent weight change (>3kg) in the previous three months, on weight-reducing medication (e.g. Orlistat or Sibutrimine), pregnancy or lactation, planning pregnancy during the timeframe of the study, an eating disorder or active psychiatric illness, serum HbA1c>9.5, diabetic nephropathy or other chronic renal failure, abnormal liver enzymes (Aspartate aminotranferase (AST), Alanine transferase (ALT) and Gamma-glutamyl transpeptidase (GGT) >3 x upper limit of normal), active gallbladder disease, heart failure (New York Heart Association class III or IV), myocardial infarction in the last six months, known malignancy within the last 5 years and not in remission, ongoing oral steroid use, or other reasons why taking part would be practically difficult (e.g. institutional care).
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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)
Baseline measures completed prior to randomisation. Computer randomised sequence at a distant site and random allocation of each individual emailed to personnel independent of those assessing outcome measures. These personnel organise allocation of the individuals into the two groups according to random allocation.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer randomised sequence at a distant site by independent person
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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
Parallel
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Other design features
The outcome assessor is blind to allocation of randomisation
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Phase
Phase 3 / Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
20/01/2007
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Actual
20/01/2007
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Date of last participant enrolment
Anticipated
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Actual
26/02/2008
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Date of last data collection
Anticipated
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Actual
1/03/2010
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Sample size
Target
450
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Accrual to date
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Final
419
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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N/A
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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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New Zealand Health Research Council
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Address [1]
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PO Box 5541, Wellesley Street, Auckland, 1141
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Country [1]
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New Zealand
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Primary sponsor type
Government body
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Name
New Zealand Health Research Council
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Address
PO Box 5541, Wellesley Street, Auckland, 1141
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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N/A
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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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Ethics committee name [1]
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New Zealand Multi-region Ethics Committee-Wellington
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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01/08/2006
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Ethics approval number [1]
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MEC/06/08/081
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Ethics committee name [2]
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New Zealand Multi-region Ethics Committee-Hutt Valley
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Ethics committee address [2]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [2]
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New Zealand
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Date submitted for ethics approval [2]
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Approval date [2]
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Ethics approval number [2]
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MEC/06/08/081
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Ethics committee name [3]
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New Zealand Multi-region Ethics Committee-Auckland
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Ethics committee address [3]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [3]
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New Zealand
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Date submitted for ethics approval [3]
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Approval date [3]
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Ethics approval number [3]
3161
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MEC/06/08/081
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Ethics committee name [4]
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New Zealand Multi-region Ethics Committee-Christchurch
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Ethics committee address [4]
3162
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [4]
3162
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New Zealand
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Date submitted for ethics approval [4]
3162
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Approval date [4]
3162
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Ethics approval number [4]
3162
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MEC/06/08/081
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Summary
Brief summary
Reducing the incidence and impact of obesity and diabetes is a priority. Diet and lifestyle modification remains the cornerstone of management. Despite the widespread promotion of low-fat/high-carbohydrate (LFHC) diets, rates of obesity continue to climb. Short-term studies in non-diabetic subjects suggest high-protein/low-carbohydrate (HPLC) diets may facilitate greater weight-loss. This randomised controlled trial will assess the impact of a HPLC diet compared with a LFHC diet in 450 overweight individuals with type 2 diabetes. Subjects will receive group-based and individualized dietitian support. Weight, diabetes control, cardiovascular disease risk, adverse effects and cost-effectiveness will be assessed over 24 months. Demonstration that a HPLC diet is effective and cost-effective without significant adverse effects in subjects with diabetes would have a wide-ranging impact for individual and public health advice both in New Zealand and internationally.
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Trial website
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Trial related presentations / publications
KREBS JD, ELLEY CR, PARRY-STRONG A, LUNT H, DRURY PL, BELL DA, ROBINSON E, MOYES SA, MANN JI, Diabetes Excess Weight Loss (DEWL) Trial: A Randomised Controlled Trial of High-Protein versus High Carbohydrate Diets over 2 years in Type 2 Diabetes Diabetologia 2012, 55, (4), 905-914, DOI 10.1007/s00125-012-2461-0
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Public notes
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Contacts
Principal investigator
Name
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Dr Jeremy Krebs
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Address
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Department of Medicine Wellington School of Medicine and Health Sciences University of Otago PO Box 7343 Wellington South
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Country
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New Zealand
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Phone
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+64 4 3855999
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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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Dr Jeremy Krebs
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Address
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Department of Medicine
Wellington School of Medicine and Health Sciences
University of Otago
PO Box 7343
Wellington South
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Country
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New Zealand
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Phone
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+64 4 3855999
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Fax
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+64 4 3855819
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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 C. Raina Elley
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Address
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Department of General Practice and Primary Health Care
School of Population Health
University of Auckland
Private Bag 91219
Auckland
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Country
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New Zealand
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Phone
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+64 9 3737599
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Fax
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+64 9 3737624
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Email
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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)?
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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
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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