Does neurocognitive training have the potential to improve dietary self-care in type 2 diabetes? Study protocol of a double-blind randomised controlled trial

Abstract

Background: Dietary self-care is a key element of self-management in type 2 diabetes. It is also the most difficult aspect of diabetes self-management. Adhering to long-term dietary goals and resisting immediate food desires requires top-down inhibitory control over subcortical impulsive and emotional responses to food. Practising simple neurocognitive tasks can improve inhibitory control and health behaviours that depend on inhibitory control, such as resisting alcohol consumption. It is yet to be investigated, however, whether neurocognitive training can improve dietary self-care in people with type 2 diabetes. The aim of this randomised controlled trial is to investigate whether web-based neurocognitive training can improve the ability of people with type 2 diabetes to resist tempting foods and better adhere to a healthy dietary regime. Methods/design: In a double-blind multicentre parallel-group randomised controlled trial, 48 patients (based on power analysis results) with type 2 diabetes recruited from secondary health care services in Birmingham and London, will be randomly allocated to either 25 online sessions of active or control working memory training. Selection criteria include being overweight/obese, having poor diabetes control and reporting to have difficulty following a healthy diet, but having good general health otherwise. Before, immediately after and 3 months after the training, assessment sessions will be conducted. Primary outcome measures include changes in working memory capacity, lab-based food intake and a 24-h guided food recall. Secondary outcome measures include changes in glycaemic control (HbA1c) and lipids. Participants' experiences of the training will be assessed qualitatively with semi-structured interviews post-training. Discussion: This is the first trial investigating whether working memory training can improve dietary self-care in people with type 2 diabetes. If effective, this could prove to be a low-cost, easy to do online training that can be used long-term without side effects. Trial registration: Current Controlled Trials ISRCTN22806944