Assessment of the effectiveness of the Defeat Diabetes Application (DDA) low carbohydrate diet and lifestyle intervention, in the self-management of type 2 diabetes.
Short description of the project and method
Our aim is to examine the effect of the Defeat Diabetes program on the clinical features of type 2 diabetes (fasting blood glucose and HbA1c), in a community-based participant cohort over a 12 month period.
The potential significance of this research project is that it may provide an adjunct modality to support the current management of T2D by the broader healthcare community.
The intervention requires participants to follow the recommendations outlined in the Defeat Diabetes program to make dietary and lifestyle changes over a 12-month period. The Defeat Diabetes program is a subscription based commercial app and web interface that provides guided education on how a low carbohydrate diet can help manage type 2 diabetes. This study relies heavily on the involvement of community-based GPs to refer patients, collect and review data in line with the RACGP clinical practice guidelines for management of type 2 diabetes at baseline, 3, 6 and 12-months. GPs will be provided with educational material on the use of low carbohydrate diets for managing type 2 diabetes, including information on how to safely deprescribe medications. They can also elect to attend GP led online education sessions, that will be conducted throughout the study period for further support.
The research team will provide supporting GPs with patient handouts for distribution to eligible patients, to assist with the recruitment process. The research team will coordinate patient appointments and data collection at the appropriate time points. Data management and collection will be via REDCap ensuring confidentiality of patient and GP information, informed consent to release health information will be obtained from participants. The research team have consulted with a small focus group of GPs to try to make data collection and reporting as simple as possible.
Supporting GPs and their nominated RN and/or practice manager will receive lifetime access to the Defeat Diabetes app.
For further information please see : https://redcap.link/defeatdiabetes_gp
Geographic location the project wishes to recruit from (State/Area)
Name of investigators/Contact person. Highlight GP investigators.
Principal Investigator: Prof. George Moschonis, School of Allied Health, Human Services & Sport, La Trobe University
Co – Investigator: Prof. Peter Brukner, School of Allied Health, Human Services & Sport, La Trobe University
Co – Investigator: A/Prof. Adrienne Forsyth, Faculty of Health Sciences, Australian Catholic University and School of Allied Health, Human Services & Sport, La Trobe University
GP Principal Investigator: Dr Liz Fraser, Co-ordinator of GP group research activity, Hobart Place General Practice, Canberra
GP External Advisory Committee: Dr Ronald Schweitzer – Senior Lecturer, Monash University and GP, East Bentleigh Medical Group, Bentleigh East, VIC; Dr Avi Charlton - GP, Wantirna Mall Clinic, Melbourne Low Carb Clinic, Wantirna, VIC; Dr Derrick Bui - GP, Town Medical Centre, Melbourne, VIC
PhD Candidate: Despina Kolivas, School of Allied Health, Human Services & Sport, La Trobe University
Contact details (Name, email address, website link)
Prof George Moschonis
Expression of Interest and support: https://redcap.link/defeatdiabetes_gp
Brief Description of participants/practices sought (inclusion and exclusion criteria, or a hyperlink to this)
Recruitment of 100 participants with type 2 diabetes, via referral from their GP, meeting the eligibility criteria below:
- Adults (men and women) meeting the clinical diagnostic criteria for type 2 diabetes
- Willingness to participate (i.e. adopt a low carbohydrate diet and make necessary lifestyle changes as detailed in the app) and be available throughout the study period of 12 months
- Be willing to attend general practitioner appointments at 3, 6 and 12 months
- Not currently using the Defeat Diabetes app, nor using a low carbohydrate diet to manage their type 2 diabetes
- Have a smartphone and can use digital technology (download and install digital applications)
- Unable to understand written and spoken English
- Liver disease (other than metabolic associated fatty liver disease) or secondary causes of MAFLD and cirrhosis
- Renal failure and patients undertaking dialysis
- Have a diagnosis of type 1 diabetes
- Are pregnant
- Are using insulin to manage their type 2 diabetes
- Excluded from participating for existing medical conditions at the discretion of their GP
Time involvement of GPs and/or practice staff, and/or patients
The time involved for supporting GPs to participate and is outlined in the attached excel template, and was designed to allocate hours for CPD.
The role of the GP practice staff is minimal.
Participants will need to see their GP for medical management for type 2 diabetes in line with RACGP Type 2 Diabetes management guidelines. Participants will need to complete health questionnaires (15 mins) and complete 3 day food records (30 mins) at baseline, 3, 6 and 12 months.
The intervention requires participants to follow the recommendations outlined in the Defeat Diabetes program to make dietary and lifestyle changes over a 12-month period.
Availability of CPD points
Yes for 2023-2025 Triennium (as advised by RACGP Kathryn Randall, CPD Program Coordinator)