Medical nutrition therapy a boon for adults with prediabetes

Medical nutrition therapy (MNT) provided by a dietitian results in improved glycaemic outcomes, anthropometrics, blood pressure, and most lipid levels in prediabetic adults, according to a systematic review and meta-analysis.

“However, most studies had a risk of bias because of the randomization process or deviations from intended interventions,” the investigators said.

Randomized controlled trials (RCTs) published between 1995 and 2022 were identified using electronic databases (ie, Medline, Cinahl, and Cochrane Central). Risk of bias was evaluated using version 2 of the Cochrane risk-of-bias tool for RCTs.

The investigators then performed meta-analyses using a random-effects model. They assessed the certainty of evidence for each outcome using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method and created a summary of findings table using the GRADEpro Guideline Development Tool.

Thirteen RCTs, representing a variety of MNT interventions delivered by dietitians, met the eligibility criteria. Duration of intervention ranged from 3 to 24 months.

MNT, compared with standard care, led to improvements in haemoglobin A1c (HbA1c; mean difference, ‒0.30 percent, 95 percent confidence interval [CI], ‒0.49 to ‒0.12) and fasting blood glucose (FBG; mean difference, ‒4.97 mg/dL, 95 percent CI, ‒6.24 to ‒3.71).

There were also significant improvements observed in anthropometrics (ie, weight, body mass index, and waist circumference), cholesterol (ie, total, high-, and low-density lipoproteins), and blood pressure (ie, systolic and diastolic). However, MNT showed no significant impact on type 2 diabetes mellitus (T2DM) or triglycerides.

Notably, evidence certainty was moderate for FBG and low for HbA1c and incidence of T2DM.

“MNT plays a key role in improving cardiometabolic risk factors in adults with prediabetes,” the investigators said.