LOADD: Lifestyle over and above drugs in diabetes

Researcher profiles:

• Dr Kirsten Coppell
• Professor Jim Mann
• Associate Professor Sheila Williams

Until recently 'lifestyle therapy' (appropriate diet and exercise) was the cornerstone of treatment for type 2 diabetes (T2DM). Drugs to lower high blood glucose, reduce raised blood pressure, and to treat abnormal blood lipid levels are now more widely prescribed than previously, and the importance of lifestyle may have been overlooked.

Examining impact of intensive dietary advice

This research aimed to examine the extent to which an intensive dietary intervention can further improve glucose, blood pressure and lipids levels, over and above the effects of recommended drugs.

Patients with established T2DM on appropriate diabetes and cardiovascular medication were randomised to receive either intensive evidence based dietary advice or 'usual' dietary advice. All participants continued to receive their usual medical care. Surrogate markers of clinical endpoints were measured.

Establishing such benefit could influence clinical practice and outcome for people with T2DM.

Improvements achievable

Intensive nutrition treatment achieved an improvement in both glycaemic control and anthropometric measures in patients with type 2 diabetes at high risk of cardiovascular disease, whose control was considered to be unsatisfactory despite optimum drug treatment.

Clinical trials

This study is registered at http://www.clinicaltrials.gov with the identifier: NCT00124553

Publications

Coppell, K.J., Kataoka, M., Williams, S.M., Chisholm, A.W., Vorgers, S.M., Mann, J.I. (2010). Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment—Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial. BMJ. 341(c3337).
View abstract