ARTÍCULO

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

Autores: Basterra Gortari, Francisco Javier; Ruiz-Canela, Miguel; Martínez González, Miguel Ángel; Babio, N.; Sorli, J. V. ; Fito, M. ; Ros, E.; Gomez-Gracia, E.; Fiol, M.; Lapetra, J.; Estruch, R. ; Serra-Majem, L. ; Pinto, X.; Gonzalez, J. I.; Bullo, M.; Castaner, O.; Alonso-Gomez, A.; Forga, L. ; Aros, F. (Autor de correspondencia)
Título de la revista: DIABETES CARE
ISSN: 0149-5992
Volumen: 42
Número: 8
Páginas: 1390 - 1397
Fecha de publicación: 2019
Lugar: WOS
Resumen:
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 Prevencion con Dieta Mediterranea (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.