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Title: Effects of a Mediterranean eating plan on the need for glucose-lowering medications in participants with type 2 diabetes: A subgroup analysis of the PREDIMED trial
Authors: Javier Basterra-Gortari, F.
Ruiz-Canela, Miguel
Martínez-González, Miguel A.
Babio, Nancy
Sorlí, José V.
Fito, Montserrat
Ros, Emilio
Gómez-Gracia, Enrique
Fiol, Miquel
Lapetra, José
Estruch, Ramón
Serra Majem, Luis 
Pinto, Xavier
González, José I.
Bulló, Mónica
Castañer, Olga
Alonso-Gómez, Ángel
Forga, Luis
Arós, Fernando
UNESCO Clasification: 32 Ciencias médicas
Keywords: Cardiovascular Risk-Factors
Style Diet
Mellitus, et al
Issue Date: 2019
Journal: Diabetes Care 
Abstract: Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at OBJECTIVE To examine the effects of two Mediterranean eating plans (Med-EatPlans) versus a low-fat eating plan on the need for glucose-lowering medications. RESEARCH DESIGN AND METHODS From the Prevención con Dieta Mediterránea (PREDIMED) trial, we selected 3,230 participants with type 2 diabetes at baseline. These participants were randomly assigned to one of three eating plans: Med-EatPlan supplemented with extra-virgin olive oil (EVOO), Med-EatPlan supplemented with mixed nuts, or a low-fat eating plan (control). In a subgroup (15%), the allocation was done in small clusters instead of using individual randomization, and the clustering effect was taken into account in the statistical analysis. In multivariable time-to-event survival models, we assessed two outcomes: 1) introduction of the first glucose-lowering medication (oral or injectable) among participants on lifestyle management at enrollment and 2) insulin initiation. RESULTS After a median follow-up of 3.2 years, in multivariable analyses adjusting for baseline characteristics and propensity scores, the hazard ratios (HRs) of starting a first glucose-lowering medication were 0.78 (95% CI 0.62-0.98) for Med-EatPlan + EVOO and 0.89 (0.71-1.12) for Med-EatPlan + nuts, compared with the control eating plan. After a median follow-up of 5.1 years, the adjusted HRs of starting insulin treatment were 0.87 (0.68-1.11) for Med-EatPlan + EVOO and 0.89 (0.69-1.14) for Med-EatPlan + nuts compared with the control eating plan. CONCLUSIONS Among participants with type 2 diabetes, a Med-EatPlan + EVOO may delay the introduction of new-onset glucose-lowering medications. The Med-EatPlan did not result in a significantly lower need for insulin.
ISSN: 0149-5992
DOI: 10.2337/dc18-2475
Source: Diabetes Care [ISSN 0149-5992], v. 42 (8), p. 1390-1397
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