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Randomised controlled trial
Intensive dietary advice significantly improves HbA(1c) in patients with type II diabetes who remain hyperglycaemic despite optimised drug treatment
  1. Deborah J Wexler,
  2. Richard W Grant
  1. Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Richard W Grant
    Massachusetts General Hospital, 50 Staniford St, 9th Floor, Boston, MA 02114, USA; rgrant{at}

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An oft-repeated but little heeded tenet of diabetes care is that diet and exercise are the foundation of therapy. This study aimed to test the value of an intensive nutritional intervention in patients with type II diabetes that remained uncontrolled despite aggressive drug treatment.


This was an unblinded, randomised clinical trial of intensive dietary advice compared with usual care for type II diabetes patients on ‘optimised’ drug therapy conducted between 2006 and 2009 in New Zealand. Eligible patients were adults younger than 70 years of age who had at least two of three cardiovascular risk factors (overweight/obese, hypertensive or on anti-hypertensive medications, and dyslipidaemic or on lipid-lowering therapy) and an HbA1c >7% despite drug therapy. Subjects with serious chronic illness or pregnancy were excluded, as were subjects who would be unwilling to adopt dietary and lifestyle changes. …

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  • Competing interests None.