What if every time a patient went to the pharmacy to renew their type 2 diabetes medication, they also got information and support to help put their disease into remission by changing the way they eat?
That was the concept behind a ground-breaking 12-week randomized controlled trial in British Columbia. The study, a partnership between UBC researchers and the IPTN, was designed to demonstrate the feasibility and effectiveness of community pharmacists teaching, coaching, and supporting patients with type 2 diabetes to put their diabetes into remission through evidence-based dietary approaches.
A total of 188 patients in 12 communities around Southern BC were randomly assigned to either the usual type 2 diabetes care, or to the intervention, which supported them adopting a low-calorie, low-carbohydrate diet.
Patients were coached to reduce the amount of sugar, and the foods that digest to sugar, in their diet and to fill up on plenty of protein and vegetables while also consuming items in a nutritionally balanced commercial, low-calorie weight-loss program. The pharmacists would then monitor and adjust the patient’s medication to keep the patients’ blood sugar in safe ranges.
Results show intervention helps patients make life changes
The results were promising. The study showed that even before any weight was lost, patients in the intervention had rapid improvement in their blood glucose levels and significant reductions in their diabetes medications. In addition, over the full length of the trial, patients who received the pharmacist support to change their diet also had significant improvements to their weight, cardiovascular risk, and quality of life compared to no improvements for those getting the usual care.
Published in Nature Communications in September 2021, the study notes that there is strong evidence that diabetes can be reversed through nutritional interventions. However, what is lacking is clear evidence for practical and effective ways that healthcare providers can safely support patients in adopting a dietary approach.
Said the authors: “This study provides RCT level evidence that community pharmacists can effectively and safely implement a dietary intervention that rapidly reduces the need for glucose-lowering medication and improves cardiometabolic health in people with type 2 diabetes within a real-world setting.”
According to the researchers, a particular strength of the study was the pragmatic use of community pharmacists, a convenient, low-cost health provider who has frequent and direct contact with the patient on glucose-lowering medications for their diabetes.
They conclude “pharmacists could be viewed as an accessible and innovative option for implementing community-based and nutritional interventions for people with type 2 diabetes.”