Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial

R. C. Andrews; A. R. Cooper; A. A. Montgomery; Alastair J Norcross; T. J. Peters; D. J. Sharp; N Jackson; K Fitzsimons; J Bright; Karen D Coulman; Clare Y England; Janet G Gorton; Amanda J McLenaghan; Elizabeth C Paxton; Anne Polet; Catherine A Thompson; C. M. Dayan

doi:10.1016/S0140-6736(11)60442-X

Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial

R. C. Andrews, A. R. Cooper, A. A. Montgomery, Alastair J Norcross, T. J. Peters, D. J. Sharp, N Jackson, K Fitzsimons, J Bright, Karen D Coulman, Clare Y England, Janet G Gorton, Amanda J McLenaghan, Elizabeth C Paxton, Anne Polet, Catherine A Thompson, C. M. Dayan

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

BACKGROUND: Lifestyle changes soon after diagnosis might improve outcomes in patients with type 2 diabetes mellitus, but no large trials have compared interventions. We investigated the effects of diet and physical activity on blood pressure and glucose concentrations. METHODS: We did a randomised, controlled trial in southwest England in adults aged 30-80 years in whom type 2 diabetes had been diagnosed 5-8 months previously. Participants were assigned usual care (initial dietary consultation and follow-up every 6 months; control group), an intensive diet intervention (dietary consultation every 3 months with monthly nurse support), or the latter plus a pedometer-based activity programme, in a 2:5:5 ratio. The primary endpoint was improvement in glycated haemoglobin A(1c)(HbA(1c)) concentration and blood pressure at 6 months. Analysis was done by intention to treat. This study is registered, number ISRCTN92162869. FINDINGS: Of 593 eligible individuals, 99 were assigned usual care, 248 the diet regimen, and 246 diet plus activity. Outcome data were available for 587 (99%) and 579 (98%) participants at 6 and 12 months, respectively. At 6 months, glycaemic control had worsened in the control group (mean baseline HbA(1c) percentage 6·72, SD 1·02, and at 6 months 6·86, 1·02) but improved in the diet group (baseline-adjusted difference in percentage of HbA(1c) -0·28%, 95% CI -0·46 to -0·10; p=0·005) and diet plus activity group (-0·33%, -0·51 to -0·14; p

Translated title of the contribution	Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial
Original language	English
Pages (from-to)	129 - 139
Number of pages	11
Journal	Lancet
Volume	378
Issue number	9786
DOIs	https://doi.org/10.1016/S0140-6736(11)60442-X
Publication status	Published - 25 Jun 2011

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Andrews, R. C., Cooper, A. R., Montgomery, A. A., Norcross, A. J., Peters, T. J., Sharp, D. J., Jackson, N., Fitzsimons, K., Bright, J., Coulman, K. D., England, C. Y., Gorton, J. G., McLenaghan, A. J., Paxton, E. C., Polet, A., Thompson, C. A., & Dayan, C. M. (2011). Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial. Lancet, 378(9786), 129 - 139. https://doi.org/10.1016/S0140-6736(11)60442-X

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title = "Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial",

abstract = "BACKGROUND: Lifestyle changes soon after diagnosis might improve outcomes in patients with type 2 diabetes mellitus, but no large trials have compared interventions. We investigated the effects of diet and physical activity on blood pressure and glucose concentrations. METHODS: We did a randomised, controlled trial in southwest England in adults aged 30-80 years in whom type 2 diabetes had been diagnosed 5-8 months previously. Participants were assigned usual care (initial dietary consultation and follow-up every 6 months; control group), an intensive diet intervention (dietary consultation every 3 months with monthly nurse support), or the latter plus a pedometer-based activity programme, in a 2:5:5 ratio. The primary endpoint was improvement in glycated haemoglobin A(1c)(HbA(1c)) concentration and blood pressure at 6 months. Analysis was done by intention to treat. This study is registered, number ISRCTN92162869. FINDINGS: Of 593 eligible individuals, 99 were assigned usual care, 248 the diet regimen, and 246 diet plus activity. Outcome data were available for 587 (99%) and 579 (98%) participants at 6 and 12 months, respectively. At 6 months, glycaemic control had worsened in the control group (mean baseline HbA(1c) percentage 6·72, SD 1·02, and at 6 months 6·86, 1·02) but improved in the diet group (baseline-adjusted difference in percentage of HbA(1c) -0·28%, 95% CI -0·46 to -0·10; p=0·005) and diet plus activity group (-0·33%, -0·51 to -0·14; p",

author = "Andrews, {R. C.} and Cooper, {A. R.} and Montgomery, {A. A.} and Norcross, {Alastair J} and Peters, {T. J.} and Sharp, {D. J.} and N Jackson and K Fitzsimons and J Bright and Coulman, {Karen D} and England, {Clare Y} and Gorton, {Janet G} and McLenaghan, {Amanda J} and Paxton, {Elizabeth C} and Anne Polet and Thompson, {Catherine A} and Dayan, {C. M.}",

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Andrews, RC, Cooper, AR, Montgomery, AA, Norcross, AJ, Peters, TJ , Sharp, DJ, Jackson, N, Fitzsimons, K, Bright, J, Coulman, KD, England, CY, Gorton, JG, McLenaghan, AJ, Paxton, EC, Polet, A, Thompson, CA & Dayan, CM 2011, 'Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial', Lancet, vol. 378, no. 9786, pp. 129 - 139. https://doi.org/10.1016/S0140-6736(11)60442-X

TY - JOUR

T1 - Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial

AU - Andrews, R. C.

AU - Cooper, A. R.

AU - Montgomery, A. A.

AU - Norcross, Alastair J

AU - Peters, T. J.

AU - Sharp, D. J.

AU - Jackson, N

AU - Fitzsimons, K

AU - Bright, J

AU - Coulman, Karen D

AU - England, Clare Y

AU - Gorton, Janet G

AU - McLenaghan, Amanda J

AU - Paxton, Elizabeth C

AU - Polet, Anne

AU - Thompson, Catherine A

AU - Dayan, C. M.

PY - 2011/6/25

Y1 - 2011/6/25

N2 - BACKGROUND: Lifestyle changes soon after diagnosis might improve outcomes in patients with type 2 diabetes mellitus, but no large trials have compared interventions. We investigated the effects of diet and physical activity on blood pressure and glucose concentrations. METHODS: We did a randomised, controlled trial in southwest England in adults aged 30-80 years in whom type 2 diabetes had been diagnosed 5-8 months previously. Participants were assigned usual care (initial dietary consultation and follow-up every 6 months; control group), an intensive diet intervention (dietary consultation every 3 months with monthly nurse support), or the latter plus a pedometer-based activity programme, in a 2:5:5 ratio. The primary endpoint was improvement in glycated haemoglobin A(1c)(HbA(1c)) concentration and blood pressure at 6 months. Analysis was done by intention to treat. This study is registered, number ISRCTN92162869. FINDINGS: Of 593 eligible individuals, 99 were assigned usual care, 248 the diet regimen, and 246 diet plus activity. Outcome data were available for 587 (99%) and 579 (98%) participants at 6 and 12 months, respectively. At 6 months, glycaemic control had worsened in the control group (mean baseline HbA(1c) percentage 6·72, SD 1·02, and at 6 months 6·86, 1·02) but improved in the diet group (baseline-adjusted difference in percentage of HbA(1c) -0·28%, 95% CI -0·46 to -0·10; p=0·005) and diet plus activity group (-0·33%, -0·51 to -0·14; p

AB - BACKGROUND: Lifestyle changes soon after diagnosis might improve outcomes in patients with type 2 diabetes mellitus, but no large trials have compared interventions. We investigated the effects of diet and physical activity on blood pressure and glucose concentrations. METHODS: We did a randomised, controlled trial in southwest England in adults aged 30-80 years in whom type 2 diabetes had been diagnosed 5-8 months previously. Participants were assigned usual care (initial dietary consultation and follow-up every 6 months; control group), an intensive diet intervention (dietary consultation every 3 months with monthly nurse support), or the latter plus a pedometer-based activity programme, in a 2:5:5 ratio. The primary endpoint was improvement in glycated haemoglobin A(1c)(HbA(1c)) concentration and blood pressure at 6 months. Analysis was done by intention to treat. This study is registered, number ISRCTN92162869. FINDINGS: Of 593 eligible individuals, 99 were assigned usual care, 248 the diet regimen, and 246 diet plus activity. Outcome data were available for 587 (99%) and 579 (98%) participants at 6 and 12 months, respectively. At 6 months, glycaemic control had worsened in the control group (mean baseline HbA(1c) percentage 6·72, SD 1·02, and at 6 months 6·86, 1·02) but improved in the diet group (baseline-adjusted difference in percentage of HbA(1c) -0·28%, 95% CI -0·46 to -0·10; p=0·005) and diet plus activity group (-0·33%, -0·51 to -0·14; p

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U2 - 10.1016/S0140-6736(11)60442-X

DO - 10.1016/S0140-6736(11)60442-X

M3 - Article (Academic Journal)

SN - 0140-6736

VL - 378

SP - 129

EP - 139

JO - Lancet

JF - Lancet

IS - 9786

ER -

Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial

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Early ACTID : Early Activity In Diabetes

COLLABORATION AND INNOVATION IN DIFFICULT OR RANDOMISED CONTROLLED TRIALS

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Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial

Abstract

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Early ACTID : Early Activity In Diabetes

COLLABORATION AND INNOVATION IN DIFFICULT OR RANDOMISED CONTROLLED TRIALS

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