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Type 2 DiabetesDiaTeleMedNCT05046886

Personalized Dietary Management in Type 2 Diabetes

A study testing Standardized and Personalized Guidance to Minimize Postprandial Glycemic Response (PPGR) in people with Type 2 Diabetes, run by NYU Langone Health at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

In a randomized trial of 255 participants with early-stage T2D, participants will be randomized to 1 of 3 groups: Standardized, Personalized, or a Usual Care Control (UCC). In the first phase, participants will be randomized with equal allocation to these 3 groups. Read more about this study

Who is it for?
Ages 21 to 80 years
Conditions the study is for
Type 2 Diabetes
What is being tested?
Standardized and Personalized Guidance to Minimize Postprandial Glycemic Response (PPGR)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
294 participants
Where
1 siteUnited States
Study dates
14 Dec 2021to 16 Jan 2026
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • must be an adult 21-80 years of age
  • must be diagnosed with early-stage T2D defined as HbA1c<8% and managed for the past 3 months on a diabetes regimen that included lifestyle plus metformin.
  • those who are willing and able to use a smart phone to self monitor their diet and to attend WebEx sessions

Who cannot join

  • those who have conditions or treatments likely to alter the underlying function of the microbiome, an insulin response that is driven by factors other than glycemic response to food, conditions/treatments that make it difficult to isolate the true nature of the relationship between randomization assignment and weight loss, characteristics or preferences that would preclude meaningful participation in the study
  • those who are unable or unwilling to adhere to an intervention that requires dietary self-monitoring
  • those who have been prescribed: (1) antibiotics or antifungals in the past 3 months, (2) diabetic medications other than metformin, (3) weight loss medications, (4) chronic use of steroids or immunosuppressants, (5) atypical antipsychotics, and (6) chemotherapy.
  • those who are pregnant, planning to become pregnant during the study period, or become pregnant during the study
  • those who have a chronic disease that affects energy/glucose metabolism (e.g., Cushing's syndrome, acromegaly, hyperthyroidism)
  • those who require special dietary management (end-stage kidney disease, cirrhosis, HIV)
Show all 15Show fewer
  • those who are unable or unwilling to provide informed consent
  • those who are unable to participate meaningfully in an intervention that involves self-monitoring using software available in English (e.g., uncorrected sight impairment, illiterate, non-English-speaking, dementia)
  • those who are unwilling to accept randomization assignment
  • those who have limited control over diet (e.g., are homeless or institutionalized, in a nursing home or personal care facility, or incarcerated)
  • those who have previously had bariatric surgery, or are unwilling to delay bariatric surgery for the next 7 months
  • those who are unable to walk without a walker or cane for 2 city blocks
  • those who have been diagnosed with a chronic active inflammatory or neoplastic disease in the past 3 years
  • those who have been diagnosed with a chronic gastrointestinal disorder (e.g., inflammatory bowel disease or celiac disease)
  • those who have an active substance use disorder

Trial locations and contacts

1 site in 1 country.

United States1 site
  • NYU Langone Health

    New York, New York, 10016

Other trials in United States

About this study

In a randomized trial of 255 participants with early-stage T2D, participants will be randomized to 1 of 3 groups: Standardized, Personalized, or a Usual Care Control (UCC). In the first phase, participants will be randomized with equal allocation to these 3 groups. In the second phase (current phase), the remaining participants will be randomized with equal allocation to the Standardized and UCC groups.

Read the detailed description

Type 2 diabetes (T2D) is an epidemic in the United States, affecting 30.2 million people. Vascular complications of T2D (heart and kidney disease, stroke, retinopathy, and amputation) are associated with poor glycemic control. However, the results of recent clinical trials (ACCORD, ADVANCE, VADT) to aggressively reduce HbA1c with medications have not resulted in cardiovascular benefits and may even be harmful due to risks of polypharmacy. Although HbA1c is directly associated with vascular complications, there is growing evidence that glycemic variability (or GV, defined by postprandial excursions and hypoglycemic nadirs) may be a better treatment target.

Postprandial glycemic excursions are primarily driven by diet. However, the results of dietary intervention studies intended to control postprandial excursions in T2D patients have been mixed and mostly negative. Importantly, these studies used one-size-fits-all dietary strategies that did not consider the fact that individuals vary greatly in their glycemic response to same foods. One-size-fits-all approaches are frustrating to T2D patients who have glycemic excursions despite their best efforts. And failure to adequately manage glycemia in the early stages of the disease has long-term vascular consequences that are not entirely remedied by subsequent, better glycemic control.

Personalized medicine is defined as "the right treatment for the right person at the right time" and has grown out of dramatic advances in genetic testing, molecular profiling, and mobile health (mHealth) technology. Personalizing dietary recommendations to the patient's unique glycemic response to food, using an algorithm derived from the gut microbiome to predict postprandial glycemic response (PPGR), is a proactive approach to early T2D dietary management that could increase mastery and self-management success beyond what can be achieved through a one-size-fits-all diet. The investigators also argue that such an approach could reduce glycemic exposure, preserve β-cell function, and reduce downstream metabolic consequences of T2D.

The purpose of this clinical trial is to determine the efficacy of a Personalized behavioral approach for dietary management of early-stage T2D, versus a Standardized behavioral intervention (which uses one-size-fits-all dietary recommendations), versus a UCC.

Primary aims. Compared to UCC, the study will determine the incremental benefits of Standardized and Personalized interventions on mean amplitude of glycemic excursion (or MAGE, the most frequently used measure of GV).

Hypothesis 1: MAGE-Personalized< MAGE-Standardized < MAGE-UCC at 6 months.

Secondary aim. At each time point, the study will describe the impact of the intervention on HbA1c.

Exploratory aims. The study will describe between-group differences in β-cell deterioration (HOMA-β) and the need to escalate the medication regimen. The study also will describe the mediating effects of changes in self-efficacy on the relationship between randomization assignment and GV, HbA1c, and HOMA-β. The study will describe the impact of the interventions on alternative measures of GV (standard deviation, coefficient of variation, Continuous Overall Net Glycemic Action, area under the curve, and frequency of out-of-range and seriously out-of-range glucose values).

Study Population

The study population includes adult men and women, 21-80 years of age, living in the New York City Metropolitan area and who have early-stage type 2 diabetes (defined as an HbA1c<8.0% and managed on lifestyle alone or lifestyle+metformin).

Description of Sites/Facilities Enrolling Participants/Sample size and Randomization

The study will enroll participants from NYU Langone Faculty Group Practices and NYU Langone affiliates located in the New York City metropolitan area. The study expects to enroll 300 individuals, and randomize 255. Participants will be stratified by medication regimen (metformin versus no metformin) and randomized within strata.

Description of Study Intervention/Experimental Manipulation

Eligible participants will be stratified by treatment with metformin (yes or no) and randomized with equal allocation to UCC, Standardized, or Personalized. All 3 groups will receive usual care plus education regarding the nature of T2D, consequences of uncontrolled glycemia, performance and interpretation of capillary glucose monitoring, and the importance of medication adherence. Participants randomized to Standardized will also experience Social Cognitive Theory (SCT)-based behavioral counseling to follow an isocaloric Mediterranean diet. Participants randomized to Personalized will receive the same SCT-based counseling as Standardized, plus personalized guidance to minimize PPGR, using a gut microbiome-based algorithm.

Measurements will occur at 0, 3, and 6 months. [screening A1c usually takes place before T=0]

Conditions
Type 2 Diabetes
Being tested
Standardized, Usual Care Control (UCC), Personalized Guidance to Minimize Postprandial Glycemic Response (PPGR)
Keywords
precision nutrition, Mediterranean diet, behavioral intervention
Medical subject headings
Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • StandardizedBehavioural

    Participants are instructed to follow a Mediterranean-style diet. Dietary counseling is paired with SCT-based behavioral counseling, which focuses on the role played by self-referent thought in the maintenance of behavior change. Self-efficacy (e.g., the participant's confidence in their ability to engage in healthier behavior) is derived from four major sources of information: mastery experiences, social modeling, verbal persuasion, and physiological states. Participants self-monitor their diet using a mobile app and receive real-time feedback from the app on macronutrient distribution.

  • Usual Care Control (UCC)Behavioural

    Participants are instructed to follow a Mediterranean-style diet,

  • Personalized Guidance to Minimize Postprandial Glycemic Response (PPGR)Behavioural

    Participants are instructed to follow a Mediterranean-style diet. Dietary counseling is paired with SCT-based behavioral counseling, which focuses on the role played by self-referent thought in the maintenance of behavior change. Self-efficacy (e.g., the participant's confidence in their ability to engage in healthier behavior) is derived from four major sources of information: mastery experiences, social modeling, verbal persuasion, and physiological states. Participants self-monitor their diet using a mobile app and receive real-time feedback from the app on their predicted PPGR to meals and snacks at the time they enter them into their smart phone. PPGR predictions will be generated from a gut microbiome-based machine learning algorithm.

Study groups in NCT05046886
Study groupRoleWhat they receive
Usual Care Control (UCC)OtherBaseline advice about the Mediterranean-style diet and attention control.
Receives: Behavioral: Usual Care Control (UCC)
StandardizedActive comparatorOne-size-fits-all dietary counseling to follow a Mediterranean-style diet
Receives: Behavioral: Standardized; Behavioral: Usual Care Control (UCC)
PersonalizedActive comparatorDietary counseling to follow a Mediterranean-style diet personalized to reduce postprandial glycemic response
Receives: Behavioral: Standardized; Behavioral: Usual Care Control (UCC); Behavioral: Personalized Guidance to Minimize Postprandial Glycemic Response (PPGR)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Amplitude of Glycemic Excursion (MAGE)

    MAGE will be evaluated via a continuous glucose monitor (CGM), which captures interstitial glucose readings every 15 minutes for up to 2 weeks from a sensor inserted into the participant's upper arm.

    Measured: Month 3

  2. Mean Amplitude of Glycemic Excursion (MAGE)

    MAGE will be evaluated via a continuous glucose monitor (CGM), which captures interstitial glucose readings every 15 minutes for up to 2 weeks from a sensor inserted into the participant's upper arm.

    Measured: Month 6

Secondary outcomes (2)
  1. HbA1c Levels

    Glycosylated hemoglobin will be evaluated from blood sampling (~10 ml) obtained during Clinical Translational Research Center (CTRC) measurement visits, evaluated in the NYU CLIA-certified lab. . Levels from 5.7% to 6.4% indicate prediabetes, while 6.5% or higher typically indicates a diabetes diagnosis.

    Measured: Month 3

  2. HbA1c Levels

    Glycosylated hemoglobin will be evaluated from blood sampling (~10 ml) obtained during CTRC measurement visits, evaluated in the NYU CLIA-certified lab. Levels from 5.7% to 6.4% indicate prediabetes, while 6.5% or higher typically indicates a diabetes diagnosis.

    Measured: Month 6

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Sep 2021
  2. Study start14 Dec 2021
  3. Primary completion22 May 2025
  4. Study completion16 Jan 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
294 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05046886
Sponsor's protocol ID
20-01088
Other IDs
1R01NR018916
Acronym
DiaTeleMed
Status last verified
May 2026
First submitted
8 Sep 2021
Last updated
18 Jun 2026
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices) will be shared.

Publications

  • Berube LT, Popp CJ, Curran M, Hu L, Pompeii ML, Barua S, Bernstein E, Salcedo V, Li H, St-Jules DE, Segal E, Bergman M, Williams NJ, Sevick MA. Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study: study protocol for a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes. Trials. 2024 Jul 25;25(1):506. doi: 10.1186/s13063-024-08337-w.

    PubMed 39049121
  • Berube LT, Popp CJ, Curran M, Hu L, Pompeii ML, Barua S, Bernstein E, Salcedo V, Li H, St-Jules DE, Segal E, Bergman M, Williams NJ, Sevick MA. Diabetes Telemedicine Mediterranean Diet (DiaTeleMed) Study: study protocol for a fully remote randomized clinical trial evaluating personalized dietary management in individuals with type 2 diabetes. Res Sq [Preprint]. 2024 Jun 25:rs.3.rs-4492352. doi: 10.21203/rs.3.rs-4492352/v1.

    PubMed 38978573

Questions about this trial

What is this clinical trial studying?

A study testing Standardized and Personalized Guidance to Minimize Postprandial Glycemic Response (PPGR) in people with Type 2 Diabetes, run by NYU Langone Health at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Jun 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Amplitude of Glycemic Excursion (MAGE) (time frame: Month 3). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05046886, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jun 2026.

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Personalized Dietary Management in Type 2 Diabetes | AzTrials