Impact of a Nutritional Intervention Based on Moroccan Dietary Habits on the Glycemic Control of Type 2 Diabetics

This study follows a quasi-experimental, before-after design conducted in a clinical setting. The research is structured to evaluate the metabolic and anthropometric response of Type 2 Diabetic (T2D) patients to a culturally tailored nutritional intervention. The trial is longitudinal, spanning a total duration of 180 days per participant.

Intervention Phases:

The protocol is divided into distinct chronological stages to capture both baseline data and intervention outcomes:

• Baseline Phase (Days 1-7): Participants maintain their habitual "free" diet to establish a baseline for glycemic variability and caloric intake. During this phase, Continuous Glucose Monitoring (CGM) systems and detailed food diaries are used to map postprandial glucose responses to traditional Moroccan meals.
• Intervention Initiation (Day 7- T7): A specialized dietitian analyzes the baseline food diaries and CGM cycles to provide personalized nutritional directives. These directives adapt international dietary standards to the specific ingredients, cooking methods, and flavor profiles of Moroccan cuisine.
• Adjustment and Stabilization (Day 14- T14): A follow-up consultation is held to assess initial adherence and refine the nutritional recommendations based on the participant's feedback and early glycemic data.
• Medium and Long-term Follow-up (T90 & T180): Metabolic stability is evaluated at 3 and 6 months. These stages involve comprehensive biological testing and anthropometric measurements to determine the sustainability of the intervention's effects.

Data collection and Scientific tools:

The study utilizes high-precision monitoring tools to ensure data reliability:

• Continuous Glucose Monitoring (CGM): Sensors are used to record interstitial glucose levels in real-time, providing a more granular view of glycemic control that traditional finger-stick testing.
• Nutritional Analysis: Food intake is quantified through structured diaries, kitchen scales for portion control, and validated food frequency questionnaires.
• Anthropometric and metabolic Markers: Bioelectrical impedance analysis (BIA) is used to track body composition changes, while laboratory tests measure HbA1c, fasting blood glucose, and lipid and renal profiles.

Statistical Analysis Plan Data will be analyzed using a within-subject comparison. Descriptive statistics will summarize baseline characteristics. Paired t-tests and ANOVA will be employed to compare glycemic and anthropometric variables across the four time points (T0, T7, T90, T180), with a significance level set to p<0.05. Additionally, Pearson or Spearman correlation tests and Artificial Intelligence techniques will examine the association between specific Moroccan dietary patterns and glycemic fluctuations.

Inclusion criteria

• Confirmed diagnosis of T2D by a healthcare professional.
• Age 18 years or older.
• A glycated hemoglobin (HbA1c) level less than 10%.
• Capacity to provide informed written consent and follow the study procedures.

Exclusion criteria

• Non-diabetic subjects.
• Type 1 diabetes or secondary diabetes.
• Age younger than 18 years.
• Pregnancy or planned pregnancy during the study period.
• HbA1c level greater than 10%.
• Chronic renal insufficiency or hepatic disease.
• Pathologies of the digestive tract that affect nutrient absorption.
• Known food allergies requiring highly specific restricted diets.