Glycemic excursion minimization in the management of type 2 diabetes: a novel intervention tested in a randomized clinical trial

Topic: Type 2 Diabetes, Lifestyle Modification, Post-Prandial Glucose

Key question: Is minimizing glycemic excursions as effective as weight loss in reducing A1C in adults with T2D?

Research Spotlight: “Glycemic excursion minimization in the management of type 2 diabetes: a novel intervention tested in a randomized clinical trial” Cox DJ, et al. BMJ Open Diabetes Res Care. 2020 Dec;8(2):e001795.

Background: Postprandial glucose excursions are a major contributor to HbA1c and may also independently contribute to diabetes complications.

Main outcomes of the study:

GEM intervention focuses on the process of glycemic excursion minimization through a variety of procedures not limited to glycemic load, moderate to vigorous exercise, and BG feedback.
GEM demonstrated a greater reduction in HbA1c (p=0.005), BMI (p=0.013), carbohydrate intake (p=0.001), BG response to a glucose challenge (p=0.02), and cardiovascular risk (p=0.003).
GEM participants significantly improved diabetes empowerment, diabetes distress, depressive symptoms, steps/day, and active hours and reduced calories/day.

Key takeaways for healthcare providers:

Reducing postnutrient glucose excursions with the GEM program through diet and exercise, resulted in a greater improvement in HbA1c and secondary benefits.
A glucose biosensor can be a tool to support healthy choices and minimize glucose spikes.

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Glycemic excursion minimization in the management of type 2 diabetes: a novel intervention tested in a randomized clinical trial

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