Appendix 2 Medication changes during the study
Run in period and safety measures
As this population was considered at high risk for macrovascular disease, a run in period was added to secure optimal diabetes and blood pressure control prior to the study start. All potential volunteers underwent a physical examination conducted by an endocrinologist. The endocrinologist monitored the volunteer’s glycaemic control, serum lipid level and blood pressure control throughout the study and adjusted medication accordingly. The endocrinologist was blinded to the diet allocation. The target serum cholesterol was <4.0, LDL cholesterol <2.0, HDL cholesterol >0.9 and triglycerides <2.0 mmol/L. The target for systolic BP was 120 and diastolic BP was 80 mmHg. The aim for HbA1c was <7% as suggested by the current guidelines [1]. Insulin was initiated if HbA1c was consistently above 8% despite maximum oral hypoglycemic treatment (two consecutive visits).
Participants were withdrawn from the study if there was a 10% or greater decline in renal function at any time confirmed on two consecutive occasions or a 20% decline in renal function at any time (no volunteer was excluded due to deterioration of renal function). There were no restrictions on medication used (including insulin) but doses were reduced to avoid hypoglycemic episodes with weight loss and energy restriction.
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