Impact of Intensive Educational Approach to Dietary Change in NIDDM

Abstract

The aim of this study was to compare the effects of an intensive educational approach incorporating longer time, greater simplicity, repetition, and cognitive motivational techniques with a conventional one in subjects with established non-insulin-dependent diabetes mellitus (NIDDM) whose weight, glycemic control, and diet were not optimal. Subjects were randomly allocated to intensive or conventional education. Of 350 subjects, 70 met the study criteria, which included established NIDDM (greater than or equal to 3 mo), suboptimal recent glycemic control, dietary fat intake greater than or equal to 35% of total energy intake, and body mass index greater than or equal to 25 kg/m2. The intensive approach was associated with significantly greater improvements in dietary compliance, dietary intake (complex carbohydrate, [P = 0.013], legumes [P less than 0.0001], fiber [P less than 0.0001], total fat [P less than 0.004], saturated fat [P less than 0.004]), and total cholesterol level (P = 0.007). The transient improvement in glycemic control was similar in both groups. An intensive education program can improve dietary compliance in established NIDDM subjects more than a conventional one. These recommended dietary improvements achieve better improvement in total cholesterol but do not necessarily improve glycemic control.

Effectiveness of Self-Management Training in Type 2 Diabetes

“…Lifestyle interventions were generally more effective in group settings, with positive outcomes noted for weight loss (8,36,47,48,72,74,76,77,94) and glycemic control (31,36,71,76,79), although two studies of lifestyle interventions in individual settings had positive effects on weight (38,80). Both individual (38,39,66 -68) and group (72,75,93) lifestyle interventions had positive effects on diet and self-care behaviors. It is notable that skills teaching was effective in both group (41,62) and individual settings (45,58).…”

“…The behavioral theories on which interventions were based are documented in a few studies (29,40,60,67,68,79,93,96), as were the behavioral tools (27,30, 46,48 -50,72,73,75,76 -78,91,92,94). However, data are insufficient to determine which behavioral tools and theories are most advantageous.…”

“…Only three studies involved didactic interventions (34,47,65), and only one of these studies showed a decrease in weight (47). A large number of studies examined the effects of self-management training on lipid levels, and some produced improvement in total cholesterol (range Ϫ0.9 to Ϫ0.07 mmol/dl) (66,68,81,83,93), LDL (Ϫ0.4 mmol/dl) (100), and HDL (ϩ0.1 mmol/dl) (100). Others found initial positive results but no significant difference from baseline at final follow-up (69,82,101).…”

Dietitians’ Perspectives on Interventions to Enhance Adherence to Dietary Advice for Chronic Diseases in Adults

“…Interventions that improve adherence are critical for reducing risk factors and preventing adverse health outcomes [8]. As greater adherence to dietary advice is an essential component for preventing the onset and progression of many diet-related chronic diseases, interventions to improve patient adherence to dietary advice using various techniques have been developed [9,10]. To identify these interventions, we conducted a Cochrane systematic review to assess the effects of interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults [11].…”

Prevalence and Risk Factors for the Development of GD in Some Eastern European Countries – Tendencies and Pharmacoeconomical Assessment for the Choice of Treatment

“…(IDF, 2004) In this project are involved all healthcare givers, including the pharmacists in order to be achieved the goals. (Douglas et al, 2000;Dixon, 2002;Campbell et al, 1990;Mensing et al, 2002) The educational approach is a necessary step for better management of the disease in order to minimize the risk of maternal and fetal complications and the pharmacists are capable to perform it. The results obtained confirm the need for consistent patients' education, using variety of educational models, as an essential part of the diabetes care that will result in improvement of patient's quality of life.…”