Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Individualized diabetes nutrition education improves compliance with diet prescription

  • Lim, Hae-Mi (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Park, Ji-Eun (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Choi, Young-Ju (21C Diabetes and Vascular Research Center) ;
  • Huh, Kap-Bum (21C Diabetes and Vascular Research Center) ;
  • Kim, Wha-Young (Department of Nutritional Science and Food Management, Ewha Womans University)
  • Published : 2009.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition education program was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided according to the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin $B_2$, and folate per 1,000 kcal/day were significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34 subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These results indicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipid concentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.

Keywords

References

  1. Albarran NB, Ballesteros MN, Morales GG & Orteqa MI (2006). Dietary behavior and type 2 diabetes care. Patient Educ Couns 61:191-199 https://doi.org/10.1016/j.pec.2005.03.008
  2. Bruce DG, Davis WA, Cull CA & Davis TM (2002). Diabetes education and knowledge in patients with type 2 diabetes from the community with type 2 diabetes from the community The Fremantle Diabetes Study. J Diabetes Complications 17:82-89 https://doi.org/10.1016/S1056-8727(02)00191-5
  3. Christensen NK, Steiner J, Whalen J & Pfister R (2000). Contribution of Medical Nutrition Therapy and Diabetes Self-management Education to Diabetes Control As Assessed by Hemoglobin A1C. Diabetes Spectrum 13:72-75
  4. Delahanty LM & Halford BN (1993). The role of diet behaviors in achieving improved glycemic control in intensively treated patients in the Diabetes Control and Complications Trial. Diabetes Care 16:1453-1458 https://doi.org/10.2337/diacare.16.11.1453
  5. Dunn SM, Beeney LJ, Hoskins PL & Turtle JR (1990). Knowledge and attitude change as predictors of metabolic improvement in diabetes education. Soc Sci Med 31:1135-1141 https://doi.org/10.1016/0277-9536(90)90235-K
  6. Elshaw EB, Young EA, Saunders MJ, McGurn WC & Lopez LC (1994). Utilizing a 24-hour dietary recall and culturally specific diabetes education in Mexican Americans with diabetes. Diabetes Educ 20:228-235 https://doi.org/10.1177/014572179402000309
  7. Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG & Davis WK (1998). The reliability and validity of a brief diabetes knowledge test. Diabetes Care 21:706-710 https://doi.org/10.2337/diacare.21.5.706
  8. Franz MJ, Monk A, Barry B, McClain K, Weaver T, Cooper N, Upham P, Bergenstal R & Mazze Rs (1995). Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: a randomized, controlled clinical trial. J Am Diet Assoc 95:1009-1017 https://doi.org/10.1016/S0002-8223(95)00276-6
  9. Genuth S, Eastman R, Kahn R, Klein R, Lachin J, Lebobitz H, Nathan D & Vinicor F, American Diabetes Association (2003). Implications of the United Kingdom prospective diabetes study (UKPDS). Diabetes Care 26:S28-S32 https://doi.org/10.2337/diacare.26.2007.S28
  10. Gray RS, Fabsitz RR, Cowan LD, Lee ET, Howard BV & Savage PJ (1998). Risk factor clustering in the insulin resistance syndrome: the Strong Heart Study. Am J Epidemiol 148:869-878 https://doi.org/10.1093/oxfordjournals.aje.a009712
  11. Hayes JT, Boucher JL, Pronk NP, Gehling E, Spencer M & Waslaski J (2001). The role of the certified diabetes educator in telephone counseling. Diabetes Educ 27:377-386 https://doi.org/10.1177/014572170102700307
  12. Hopkins PN, Hunt SC, Wu LL, Williams GH & Williams RR (1996). Hypertension, dyslipidemia, and insulin resistance: links in a chain or spokes on a wheel? Curr Opin Lipidol 7:241-253 https://doi.org/10.1097/00041433-199608000-00011
  13. Jiang YD, Chuang LM, Wu HP, Shaiau SJ, Wang CH, Lee YJ, Juang JH, Lin BJ & Tai TY (1999). Assessment of the function and effect of diabetes education programs in Taiwan. Diabetes Res Clin Pract 46:177-182 https://doi.org/10.1016/S0168-8227(99)00085-6
  14. Johnson EQ & Valera S (2001). Medical nutrition therapy by registered dietitians improves HbA1c levels (Abstract). Diabetes 50:A21
  15. Kim HS & Oh JA (2003). Adherence to diabetes control recommendations: impact of nurse telephone calls. Nurse Educ Pract 44:256-261 https://doi.org/10.1046/j.1365-2648.2003.02800.x
  16. Kim YS & Seung JJ (1985). A study on the Evaluation of Diet-Education Program of Diabetes. Journal of Korean Diabetes Association 10:191-196
  17. Ko SH, Song KH, Kim SR, Lee JM, Kim JS, Shin JH, Cho YK, Park YM, Jeong JH, Yoon KH, Cha BY, Son HY & Ahn YB (2007). Long-term effects of a structured intensive diabetes education program (SIDEP) in patients with type 2 diabetes mellitus-a 4 year follow-up study. Diabet Med 24:55-62 https://doi.org/10.1111/j.1464-5491.2007.02013.x
  18. Lee KU, Choi YA, Lee YH, Park SW, Yoo HJ, Kim SY, Lee HK & Min HK (1985). Development of a diabetes knowledge test. Journal of Korean Diabetes Association 9:89-93
  19. Lee YA (2007). The effect of nutrition education on diet quality and weight loss in middle-aged women. Master's Thesis. Ewha Womans University Graduate School, Seoul. Republic of Korea
  20. Lemon CC, Lacev K, Lohsw B, Hubacher DO, Klawitter B & Palta M (2004). Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes. J Am Diet Assoc 104:1805-1815 https://doi.org/10.1016/j.jada.2004.09.024
  21. Lim HS, Chyun JH, Kim YS & Nam MS (2001). Effect of nutrition education on diabetic management in diabetic patients. The Korean Journal of Nutrition 34:69-78
  22. Lindstorm J, Louheranta A, Manelin M, Rastas M, Salminen V, Erilsson J, Uusotupa M & Tuomilehto J (2003). The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3 year results in diet and physical activity. Diabetes Care 26:3230-3236 https://doi.org/10.2337/diacare.26.12.3230
  23. Maljanian R, Grey N, Staff I & Conroy L (2005). Intensive telephone follow-up to a hospital based disease management model for patients with diabetes mellitus. Dis Manag 8:15-25 https://doi.org/10.1089/dis.2005.8.15
  24. Miller CK, Edwards L, Kissling G & Samville L (2002). Nutrition education improves metabolic outcomes among older adults with diabetes mellitus: results from a randomized controlled trial. Prev Med 34:252-259 https://doi.org/10.1006/pmed.2001.0985
  25. Norris SL, Engelgau MM & Narayan KM (2001). Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care 24:561-587 https://doi.org/10.2337/diacare.24.3.561
  26. Oh SY, Kim EM, Shin MH, Lee SH, Kim JE, Lee HS, Cho JS & Kim WY (2007). Development and validity of food frequency questionnaire for adults. The Korean Society of Health Promotion. Annual Spring Conference, Seoul. Republic of Korea
  27. Park JS & Ahn CW (2007). Educational program for diabetic patients in Korea-multidisplinary intensive management. Diabetes Res Clin Pract 77:S194-198 https://doi.org/10.1016/j.diabres.2007.01.056
  28. Shabbidar S, Fathi B & Shirazifard M (2006). Effects of clinical nutrition education on glycemic control outcomes in type 2 diabetes. International Journal of Diabetes in Developing Countries 26:156-159 https://doi.org/10.4103/0973-3930.33181
  29. Woo YJ, Lee HS & Kim WY (2005). Individual Diabetes Nutrition Education Can Help Management for Type 2 Diabetes. The Korean Journal of Nutrition 39:641-648

Cited by

  1. Middle School-Aged Child Enjoyment of Food Tastings Predicted Interest in Nutrition Education on Osteoporosis Prevention vol.85, pp.7, 2015, https://doi.org/10.1111/josh.12268
  2. A Retrospective Cross-sectional Analysis of Health Education Disparities in Patients With Diabetes Using Data From the National Ambulatory Medical Care Survey vol.43, pp.1, 2017, https://doi.org/10.1177/0145721716685408
  3. Non-adherence to diet and exercise recommendations amongst patients with type 2 diabetes mellitus attending Extension II Clinic in Botswana vol.5, pp.1, 2013, https://doi.org/10.4102/phcfm.v5i1.457
  4. Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: changes in health cognitions and glycemic control vol.18, pp.1, 2009, https://doi.org/10.1186/s12889-018-5640-1
  5. Importance of Adherence to Personalized Diet Intervention in Obesity Related Metabolic Improvement in Overweight and Obese Korean Adults vol.8, pp.3, 2009, https://doi.org/10.7762/cnr.2019.8.3.171