Can a personalized diet improve glycaemic variability, HbA1c in prediabetic adults?

Adherence to a personalized calorie-restricted, weight-loss diet falls short of reducing glycaemic variability (GV) or glycated haemoglobin (HbA1c) relative to a one-size-fits-all low-fat (standardized) diet among patients with prediabetes and moderately controlled type 2 diabetes, a study has shown.

Of the 156 participants (mean age 59.1 years, 66.5 percent women, 55.7 percent White, 24.1 percent Black) included in the analyses, 75 received the standardized diet and 81 the personalized diet.

The mean amplitude of glycaemic excursions (MAGEs) decreased by 0.83 mg/dL per month (95 percent confidence interval [CI], 0.21‒1.46; p=0.009) for the standardized diet and by 0.79 mg/dL per month (95 percent CI, 0.19‒1.39; p=0.010) for the personalized diet, with no significant between-group differences (p=0.92). Such trends were also seen for HbA1c values.

“Additional subgroup analyses may help to identify patients who are more likely to benefit from this personalized intervention,” the researchers said.

This randomized controlled trial compared a one-size-fits-all low-fat diet with a personalized diet. Both groups received behavioural weight loss counseling and self-monitored their diets using a smartphone application. The personalized arm also received feedback through the application to reduce their postprandial glucose response.

The researchers collected the continuous glucose monitoring data at baseline, 3 months, and 6 months. They assessed changes in MAGE and HbA1c at 6 months, as well as conducted an intention-to-treat analysis using linear mixed regressions.