Basterra-Gortari, F. JavierRuiz-Canela, MiguelMartínez-González, Miguel Ángel, 1957-Babio, NancySorlí, José VicenteFitó Colomer, MontserratRos, EmilioGómez-Gracia, EnriqueFiol, MiquelLapetra, JoséEstruch, RamónSerra-Majem, LuisPinto, XavierGonzález, José I.Bulló, MònicaCastañer, OlgaAlonso-Gómez, ÁngelForga, LuisArós, FernandoPREDIMED investigators2019-12-032019-12-032019Basterra-Gortari FJ, Ruiz-Canela M, Martínez-González MA, Babio N, Sorlí JV, Fito M. et al. 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. Diabetes Care. 2019 Aug;42(8):1390-1397. DOI 10.2337/dc18-24750149-5992http://hdl.handle.net/10230/43056OBJECTIVE: 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 Prevención con Dieta Mediterránea (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.application/pdfeng© American Diabetes Association. This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care. The American Diabetes Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes in print and online at http://diabetes.diabetesjournals.org.Dieta -- Mediterrània, Regió de laDiabetisinfo:eu-repo/semantics/articlehttp://dx.doi.org/10.2337/dc18-2475info:eu-repo/semantics/openAccess