Very Low-Carbohydrate Breakfast Intervention for Adults with Type 2 Diabetes and Persistent Hyperglycemia: Protocol
Annika Hansen1, Kaitlyn Raymond2, Alexander Simon2
1School of Medicine, University of Utah, Salt Lake City, UT, United States.
JMIR Research Protocols
|January 28, 2026
Summary
This study tested a digital, small-steps intervention for a very low-carbohydrate breakfast in adults with type 2 diabetes and hyperglycemia. The approach aims to improve glycemic control and reduce medication needs without major dietary changes.
Area of Science:
- Endocrinology
- Nutrition Science
- Digital Health
Background:
- Persistent hyperglycemia affects over 15% of US adults with type 2 diabetes, increasing risks for amputation and mortality.
- Nutrition interventions can improve glycemic control, but complex diets pose adherence challenges, especially for those with low health literacy.
- The American Diabetes Association recommends very low-carbohydrate diets for type 2 diabetes management due to their effectiveness in improving glycemic control.
Purpose of the Study:
- To evaluate a digital, small-steps intervention focused on very low-carbohydrate breakfasts for adults with type 2 diabetes and persistent hyperglycemia.
- To determine if this targeted dietary modification reduces hemoglobin A1c (HbA1c) and antihyperglycemic medication use.
- To assess the intervention's effectiveness without requiring participants to overhaul their entire diet.
Main Methods:
- Enrollment of adults with HbA1c ≥7.0% in a 4-month online intervention focused on very low-carbohydrate breakfasts.
- Measurement of acceptability, feasibility, HbA1c, antihyperglycemic medications, glycemic variability, body weight, blood pressure, and lipids.
- Exploration of moderation effects by sex and baseline insulin resistance on intervention outcomes.
Main Results:
- 119 participants enrolled as of October 2025.
- Full results will be published separately.
Conclusions:
- The Breakfast Study is a pre-post trial assessing the acceptability, feasibility, and preliminary effectiveness of a very low-carbohydrate breakfast intervention.
- This accessible approach may help lower barriers to dietary interventions for type 2 diabetes management.
- Findings could support further research into effective, manageable dietary strategies for type 2 diabetes.
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