Evidence map›Paper›PMID 41093350›Full record

ArticleBMJ open2025

Effectiveness of primary care-led low-carbohydrate diet and self-management advice on glycaemic control in individuals with type 2 diabetes mellitus: protocol of a cluster randomised controlled trial.

Joshua Chadwick, Parasuraman Ganeshkumar, Kathiresan Jeyashree, Hemant Deepak Shewade, Madhanraj Kalyanasundaram, Devika Shanmugasundaram, Lokesh Shanmugam

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joshua ChadwickICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India joshuachadwick89@gmail.com.ORCID http://orcid.org/0000-0002-8636-0634
Parasuraman GaneshkumarNational Institute of Epidemiology, Chennai, India.ORCID http://orcid.org/0000-0001-7466-7965
Kathiresan JeyashreeNational Institute of Epidemiology, Chennai, India.ORCID http://orcid.org/0000-0001-6459-3659
Hemant Deepak ShewadeHealth System Research, ICMR - National Institute of Epidemiology, Chennai, India.
Madhanraj KalyanasundaramICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
Devika ShanmugasundaramNational Institute of Epidemiology, Chennai, India.
Lokesh ShanmugamICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.ORCID http://orcid.org/0000-0003-4348-1572

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDietary modification, particularly low-carbohydrate diet, and diabetes self-management education (DSME) have shown promise in improving glycaemic control among persons with type 2 diabetes mellitus (T2DM). However, real-world evidence from India is limited. This protocol describes the methods of a cluster randomised trial to determine the effectiveness and feasibility of adopting a low-carbohydrate diet among persons with T2DM. METHODS AND ANALYSIS: Our cluster-randomised trial with a mixed-method process evaluation will use computer-generated block randomisation sequence to randomise Urban Primary Health Centres (UPHCs) (n=16) to either continue delivering the usual guideline-based care under the National Programme for Prevention and Control of Non-Communicable Diseases (NPNCD) or our study intervention. The study intervention will comprise a personalised nutrition counselling focusing on (i) low-carbohydrate diet (<130 g/day) (ii) diabetes self-management principles. A primary care nurse will deliver the intervention at baseline, 3, 6, 9 and 12 months.We will include persons with T2DM, over the age of 30 years and above, irrespective of comorbidities, registered in the selected UPHC under care for diabetes for at least a month and with an glycated haemoglobin (HbA1c) level ≥6.5% during the screening test. We will collect data electronically using semistructured questionnaires and measure HbA1c, blood pressure, lipid profile, serum creatinine and body weight at baseline, 3, 6, 9 and 12 months after enrolment. We will use a difference in difference analysis, adjusted for clustering, to compare the change in HbA1c at the follow-up visits compared with baseline across the two study arms. We will conduct both intention-to-treat and per-protocol analysis, exploring reasons for differences in effect size. ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the Scientific Advisory Committee/Institutional Human Ethics Committee of the research institution (NIE/IHEC/202302-03). The findings of this study will be disseminated through publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Clinical Trials Registry-India (CTRI/2024/02/062202).

Indexed as

Diabetes Mellitus, Type 2Diet, Carbohydrate-RestrictedGlycemic ControlSelf-ManagementAdultBlood GlucoseFemaleGlycated HemoglobinHumansIndiaMalePrimary Health CareRandomized Controlled Trials as TopicBlood GlucoseGlycated HemoglobinClinical trialsDiabetes Mellitus, Type 2Feasibility StudiesHealth EducationPrimary Care

Identifiers

PMID41093350
PMCPMC12530426

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.