Type 2 Diabetes
Conditions
Brief summary
Large spikes in blood glucose experienced after meals in people with type 2 diabetes are known to damage blood vessels. Low carbohydrate high fat diets and exercise can improve blood glucose control in people with type 2 diabetes but it is unclear how these two strategies interact to affect blood vessel function and inflammation. We will examine how following a short-term low carbohydrate high fat diet (4 days) with or without post-meal walking impacts markers of blood vessel function and inflammation. We will also examine how a single low carbohydrate high fat meal, with or without post-meal walking, impacts blood glucose control and blood vessel function. Findings will help determine the best lifestyle approach for improving cardiovascular health in type 2 diabetes.
Interventions
BEHAVIORALHigh-carbohydrate diet
Participants will engage in 4 days of high-carbohydrate low fat diet as recommended by the Canadian Diabetes Association. The macronutrients content will go as follow: 55% carbohydrate, 25% protein and 20% fat. Breakfast, lunch and dinner will be provided to the participants as part of an isoenergetic diet. Between interventions there will be at least a one-week washout, where participants are encouraged to return to their baseline dietary habits.
BEHAVIORALLow-carbohydrate diet
Participants will engage in 4 days of low-carbohydrate high-fat diet. The macronutrients content will go as follow: 10% carbohydrate, 25% protein and 65% fat. Breakfast, lunch and dinner will be provided to the participants as part of an isoenergetic diet. Between interventions there will be at least a one-week washout, where participants are encouraged to return to their baseline dietary habits.
BEHAVIORALLow-carbohydrate diet with post-meal walking
Participants will follow the same diet as in the low-carbohydrate diet arm but also perform 15 minutes of walking beginning \ 15 minutes after breakfast, lunch and dinner. Approximately 70 kcal (individualized) will be added to main meals to account for exercise energy expenditure. Between interventions there will be at least a one-week washout, where participants are encouraged to return to their baseline dietary habits.
Sponsors
Medtronic
University of British Columbia
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed with type 2 diabetes (at least 6 months ago) * Aged 40-75 * Engaging in 2 or less moderate-to-vigorous exercise bouts per week in the last 3 months * Ability to understand and communicate in English to interact with the personal trainer
Exclusion criteria
* Diagnosed coronary artery disease * Any contraindications to exercise (e.g., musculoskeletal injury) * Prior history of cardio- or cerebrovascular disease or myocardial infarction * Hypertension that is not controlled by medication (systolic blood pressure (BP) \>160 mmHg and/or diastolic BP \>99 mmHg) * Change in diabetes medications in the previous 6 months * Diagnosed with peripheral neuropathy * Taking exogenous insulin
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Difference in glycemic control assessed by continuous glucose monitoring in low-carbohydrate, low-carbohydrate plus post-meal walking, and high-carbohydrate low-fat arm. | 4-day average glucose levels assessed in each arm. |
Secondary
| Measure | Time frame |
|---|---|
| Change from baseline in circulating inflammatory cytokines after 4 days of intervention. | Fasting measurements taken on day 1 and day 5. |
| Change from baseline in toll-like receptors 2 and 4 expression on white blood cells after 4 days of intervention. | Fasting measurements taken on day 1 and day 5. |
| Change from baseline in flow mediated dilation of brachial artery after 4 days of intervention. | Fasting measurements taken on day 1 and day 5. |
Other
| Measure | Time frame |
|---|---|
| Change from baseline in plasma glucose after single breakfast meal on day 1 of the intervention | Baseline and 1, 2, and 3 hours post-breakfast on day 1 in each arm |
| Change from baseline in body weight after a single meal and 4 days of intervention. | Fasting measures on day 1 and day 5. |
| Change from baseline in flow-mediated dilation after single breakfast meal on day 1 of the intervention | Baseline and 1, 2, and 3 hours post-breakfast on day 1 in each arm |
Countries
Canada
Outcome results
None listed