Basterra-Gortari, F JavierRuiz-Canela, MiguelMartínez-González, Miguel ABabio, NancySorlí, José VFito, MontserratRos, EmilioGómez-Gracia, EnriqueFiol, MiquelLapetra, JoséEstruch, RamónSerra-Majem, LuisPinto, XavierGonzález, José IBulló, MónicaCastañer, OlgaAlonso-Gómez, ÁngelForga, LuisArós, FernandoPREDIMED Study Investigators2023-01-252023-01-252019-06-10http://hdl.handle.net/10668/14097To examine the effects of two Mediterranean eating plans (Med-EatPlans) versus a low-fat eating plan on the need for glucose-lowering medications. 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. 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. 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.enAgedBlood GlucoseDiabetes Mellitus, Type 2Diet, Fat-RestrictedDiet, MediterraneanFemaleHumansHypoglycemic AgentsMaleMiddle AgedMultivariate AnalysisOlive OilPropensity ScoreProportional Hazards ModelsTreatment Outcomeresearch article31182491open access10.2337/dc18-24751935-5548PMC6647050https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647050https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647050/pdf