2764-LB: Very Low-Carbohydrate Breakfast Intervention for Adults with Type 2 Diabetes: Results from a Digital, Nonrandomized Pre–Post Study

Introduction and Objective: A very low-carbohydrate diet can improve glucose control in adults with type 2 diabetes, but there are many factors that may impact the ability to completely change one's diet. Emerging evidence suggests that altering only breakfast to be very low-carbohydrate may improve glucose control as well. Therefore, the purpose of this pilot study was to assess the impact of an online very low-carbohydrate breakfast program for adults with type 2 diabetes. Methods: Over 16 weekly sessions, the program taught participants to consume breakfast, or their first meal of the day, with <10 grams of non-fiber carbohydrates, about 20-30 grams of protein, and about 350-500 calories. The study was an open-label, single-arm, pre-post intervention of adults with a baseline HbA1c of at least 7.0%. We examined feasibility (retention), acceptability (intervention satisfaction: “How would you rate your overall satisfaction with the program?” on a 0-6 Likert scale), and HbA1c change from baseline to 4 months. Paired t-tests were used to compare HbA1c levels between time points. Results: Participants (mean age 61.1 ± 11.1 years; 61.3% female) had a mean baseline HbA1c of 8.8% ± 1.1%. Retention was high; 115/119 participants (97%) completed the 4-month follow-up. Participant satisfaction was also high (5.4/6.0 ± 0.9). At 4 months, the mean change in HbA1c was −0.4% (95% CI: -0.6, -0.2; p < 0.001). Conclusion: The program was feasible, acceptable, and effective, as evidenced by high retention, high satisfaction, and a reduction in HbA1c levels. This very low-carbohydrate breakfast-only intervention may offer a scalable, sustainable approach for metabolic improvement. Disclosure L. Saslow: None. K. Raymond: None. B. Riedel: None. A.J. Arnold: None. D. Marriott: None. A. Hansen: None. L. Khadr: None. D.Y. Lee: None. S. Kim: None. Funding National Institutes of Health (DK132099)