Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Potential for Diet Modification to Improve Glycaemic Control and Cardiovascular Risk Factors Over and Above Drug Therapy in Type 2 Diabetes at High Risk of Cardiovascular Disease
Brief Summary: In the past, nutritional management formed the cornerstone of treatment of type 2 diabetes (T2DM). More recently, this aspect of treatment has received less attention as drug therapy aimed not only to lower glucose, but also to treat raised blood pressure and blood fats (including cholesterol) has been more widespread. While there is evidence to suggest that blood pressure and blood fat levels have improved, overall diabetes control has not and people with diabetes appear to be becoming progressively more overweight, following trends in the general population. The proposed study involves a randomised controlled trial in which people with T2DM continuing with their regular drug treatment and surveillance, will be randomly allocated to additionally receive intensive advice regarding diet or remain on their usual treatment in this regard. The results will be judged principally in terms of body weight, waist circumference, blood pressure, blood glucose control and blood fats.


Options:
A: Inclusion Criteria:

* Type 2 diabetes
* Resident in Dunedin
* Aged \<70 years at the time of invitation to participate
* Most recent HbA1c level within the last 12 months ≥ 7%
* Currently prescribed oral tablets or insulin or both for glycaemic control AND three of the following: \*Any pre-existing cardiovascular disease defined as a past history of myocardial infarction, angina, peripheral vascular disease, cerebrovascular accident, transient ischaemic attack; \*Currently prescribed antihypertensive medication; \*Currently prescribed lipid modifying medication; \*Body mass index ≥25

Exclusion criteria:

* Terminal illness
B: Inclusion Criteria:

* Presence of a medical diagnosis of diabetes for at least 6 months
* HbA1c \< 9%
* Age greater than 18 years
* Resident of Loma Linda, California area

Exclusion Criteria:

* Allergy to peanuts
* Smokers
* History of irritable bowel disease or diverticulitis
* Statin therapy (unless stable statin dose for 3 months)
C: Inclusion Criteria:

* Male and female age 25-75 years;
* Non-smoker;
* High risk for diabetes, defined as meeting at least one of the criteria listed below:

  a. Overweight with increased waist circumference; b.Pre-diabetes: fasting blood glucose \>100mg/dL and \<126mg/dL or HbA1C 5.7-6.4 % c. Metabolic syndrome, i.e. meet three out of five of the following criteria: i.Blood pressure \>130/85 mmHg or currently taking antihypertensive medication; ii. Fasting plasma glucose (FPG) \>100 mg/dL (6.1 mmol/L); iii.Serum triglycerides level (TG)\>150 mg/dL (1.69 mmol/L); iv. High-density lipoprotein (HDL) cholesterol \< 40 mg/dL (1.04 mmol/L) in men, and \< 50 mg/dL (1.29 mmol/L) in women; v. Overweight (BMI ≥25kg/m²) with waist circumference of more than 40 inches (102 cm) for men and more than 35 inches (88 cm) for women.

Exclusion Criteria

* Allergy to walnuts or any other nuts;
* Anticipated inability to complete study protocol for any reason;
* Current eating disorder;
* Restricted diets by choice (i.e., vegetarian, vegan);
* Receiving pharmacotherapy for obesity, including appetite suppressant
* Unstable use of lipid-lowering, antihypertensive medications or aspirin (i.e. dose has changed in the three months prior to enrollment) or unwilling to refrain from taking medication for 12 hours prior to endothelial function scanning;
* Regular use of high doses of vitamin E (\>400IU/day) or vitamin C (\>500mg/day); fish oil, flaxseed oil, omega-3 fatty acid and fiber supplement unless welling to discontinue supplementation for the study duration.
* Use of insulin, glucose-sensitizing medication, vasoactive medication (including glucocorticoids, antineoplastic agents, psychoactive agents, or bronchodilators);
* Diagnosed diabetes;
* Diagnosed sleep apnea;
* Established cardiovascular disease (including symptomatic coronary artery disease (CAD), myocardial infarction, peripheral vascular disease, congestive heart failure, carotid stenosis);
* Coagulopathy, known bleeding diathesis, or history of clinically significant hemorrhage; current use of warfarin;
* Regular exercise defined as participation in moderate-intensity exercise \> 150 minutes/week.
* Substance abuse (chronic alcoholism, other chemical dependency)
* Any unstable medical condition that would limit the ability of a subject to participate fully in the trial (e.g., cancer, AIDS, tuberculosis, psychotic disorder)
* Women who get Depo-Provera shots
* Women who are pregnant or lactating
* Women who are currently on hormone replacement therapy
* Substance abuse (chronic alcoholism, other chemical dependency)
* Any unstable medical condition that would limit the ability of a subject to participate fully in the trial (e.g., cancer, AIDS, tuberculosis, psychotic disorder)
D: Inclusion Criteria:

* Between 18 and 50 years of age
* Weight stable (\< 3 kg weight change within last 3 months)
* Constant habitual activity patterns (no deviation \> 1x/wk at 30 min/session within last 3 months)
* Constant habitual diet patterns within last 3 months
* Willingness to eat all test foods (peanuts daily for 12 weeks)
* No allergy to foods provided in the study (peanuts)
* Not a daily peanut or tree nut consumer
* Not planning to change use of medications known to influence appetite or metabolism
* Not diabetic or hypertensive
* No history of gastrointestinal pathology
* Non-smoker for one year or more

Exclusion Criteria:

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Answer: A