N/A
N=58
Delish Study: Diabetes Education to Lower Insulin, Sugars, and Hunger
Diabetes Mellitus, Type 2
Bottom Line
View on ClinicalTrials.gov: NCT03207711 ↗Enrolled (actual)
58
Serious AEs
0.0%
Results posted
Dec 2025
Primary outcome: Primary: Frequency of Eating in Response to Cravings (Primary Mechanistic Outcome) — -20.39; -25.27 % of EMAs with craving related eating
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Carbohydrate-restricted diet (Behavioral); Mindfulness (Behavioral)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- University of California, San Francisco
- Primary completion
- Apr 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Frequency of Eating in Response to Cravings (Primary Mechanistic Outcome) |
-20.39; -25.27 | — |
| SECONDARY Change in Impulsivity as Measured by Delayed Discounting Score |
87.17; 6.42 | — |
| SECONDARY Emotion-related Eating (Secondary Mechanistic Outcome) |
-0.62; -0.90 | — |
| SECONDARY Stress-related Eating (Secondary Mechanistic Outcome) |
-1.62; -1.73 | — |
| SECONDARY Glycemic Control, Using HbA1c |
-1.32; -0.87 | — |
| SECONDARY Fasting Glucose |
-30.21; -25.92 | — |
| SECONDARY HOMA-2IR Index of Insulin Resistance (Secondary Clinical Outcome) |
-0.45; -0.85 | — |
| SECONDARY Weight Change(Secondary Clinical Outcome) |
-4.96; -4.43 | — |
| SECONDARY Adherence to Diet as Measured by Fingerstick Blood Ketones |
0.46; 0.60 | — |
| SECONDARY Diet Adherence by Mean Grams of Non-fiber Carbohydrate Consumed Per Day |
-91.43; -116.92 | — |
| SECONDARY Perceived Stress |
-1.09; -2.04 | — |
Summary
Type 2 diabetes mellitus (T2DM) is the most expensive chronic disease in the U.S.
Lifestyle modification is central to T2DM management, but long-term adherence to dietary recommendations is difficult. A key challenge is the difficulty of coping with cravings for high carbohydrate or sugar-laden foods in an environment where these foods are tempting and widely available. One mechanism by which mindfulness may increase long-term dietary adherence is by better equipping individuals with skills to experience food cravings and difficult emotions without eating in response. Such approaches seek to strengthen abilities to be non-judgmentally aware of, tolerate, and respond skillfully to food cravings and difficult emotions without reacting impulsively or maladaptively. The investigators hypothesize that improved ability to manage food cravings and emotional eating is a key mechanism through which mindfulness-enhancements can improve dietary adherence. The study will test a mindfulness-based intervention (MBI) for improving dietary adherence. Although the particular diet employed is not the focus of this study, the study will use a diet with about 10% of calories from carbohydrate as: (1) it induces a low level of ketone production, which will be used as a biomarker for dietary adherence; (2) prior studies suggest it improves metabolic parameters in T2DM, including glycemic control.
Eligibility Criteria
Inclusion Criteria
- History of T2DM mellitus. If taking insulin, screening labs will include C-Peptide to rule out T1DM.
- HbA1c >= 6.5% and < 12.0% at screening.
- Experience food-related cravings most days of the week and eat in response to these cravings regularly.
- Aged 18 years old and older.
- Able to engage in light physical activity.
- Willing and able to participate in the interventions. Must be interested in following a carbohydrate- restricted diet, willing to learn about mindful eating and behavioral strategies for following prescribed diets, have sufficient control over their food intake so that they can follow either diet, and otherwise be able and willing to participate in the intervention. Intervention content must be practiced to evaluate whether it is effective.
- Have smartphone and are willing to use it on a regular basis for data collection.
- Ability to speak English.
Exclusion Criteria
- Unable to provide informed consent.
- A substance abuse, mental health, or medical condition that, in the opinion of investigators, will make it difficult for the potential participant to participate in the intervention or that may need immediate changes in medical management that will affect study outcome measures. Such conditions may include cancer, liver failure, renal failure, untreated hypo or hyperthyroidism, or history of serious bulimia. Some other serious medical conditions that may alter key study outcomes or require other important diet modifications, including untreated hypothyroidism, renal failure, cirrhosis, and conditions requiring oral or parenteral glucocorticoid treatment.
- Pregnant or planning to get pregnant in the next 6 months, breastfeeding or less than 6 months post-partum.
- Current use of weight loss medications, such as Alli or amphetamine-based drugs that may affect weight.
- Planned weight-loss (bariatric) surgery or bariatric surgery within the past 18 months.
- Currently enrolled in a weight loss program, such as Weight Watchers or a self-help group such as Overeaters Anonymous, or have unalterable plans to enroll in one of these programs in the next year.
- Vegan or vegetarian.
- Unwilling to do home ketone monitoring.
Data sourced from ClinicalTrials.gov (NCT03207711). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.