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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

AuthorsBasterra-Gortari, F. Javier; Ruiz-Canela, Miguel; Martínez-González, Miguel Ángel; Babio, Nancy; Sorlí, José V.; Fitó, Montserrat; Ros, Emilio; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, Jose; Estruch, Ramón; Serra-Majem, Lluis; Pintó, Xavier; González, José I.; Bulló, Mònica; Castañer, Olga; Alonso-Gómez, Ángel M.; Forga, Luis; Arós, Fernando
Issue DateAug-2019
PublisherAmerican Diabetes Association
CitationDiabetes Care 42(8): 1390 (2019)
Abstract[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.
Publisher version (URL)http://dx.doi.org/10.2337/dc18-2475
URIhttp://hdl.handle.net/10261/213058
DOI10.2337/dc18-2475
ISSN0149-5992
E-ISSN1935-5548
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