Effect of simple dietary advice or a low calorie diet program supplemented with psyllium on glycemic control and inflammatory cytokines in patients with type 2 diabetes

Objectives: To examine the impact of simple dietary advice or a structured low-calorie diet program on glycemic control, lipid profile and inflammatory cytokines in patients with type 2 diabetes. Design: This is an open randomized controlled trial with two parallel groups. Thirty-six diabetic patients will be randomized into two groups: 1-Diet program (diet group), 2- Simple nutrition advice (advice group). Participants: Type 2 diabetic patients that are not using insulin and have no history of diabetic retinopathy. Setting and conduct: Participants will be followed for 8 weeks. Fasting and 2-hour postprandial (after a standard breakfast) venous blood samples will be taken at baseline and after 8 weeks of dietary modification. Dietary compliance will be assessed through 24-hour dietary recall. Intervention: In the advice group, patients are given simple dietary advice on single occasion aimed to modulate carbohydrate intake (to reduce consumption of simple sugars and foods containing added simple sugars, avoidance of overeating too much refined carbohydrate and replacement with whole grain foods). In diet group, diet program will be developed for each patient based on anthropometric, dietary and physical activity assessments with energy intake deficits of 25% of total calculated energy requirements. In this group, macronutrient distribution will be 55%from carbohydrate, 25% fat, and 20% protein. In addition, patients will be instructed to ingest a tablespoon of psyllium powder dissolved in one glass of water at the evening. Main outcome measures: Plasma concentrations of glucose, insulin.

Shahid Beheshti University of Medical Sciences