Increased vegetable intake improves glycaemic control in adults with type 2 diabetes mellitus: a clustered randomised clinical trial among Indonesian white-collar workers

Abstract

Dietary patterns high in fibre and green leafy vegetables have shown an inverse association with lower risks of type 2 diabetes mellitus and improved glycaemic control. The study aimed to investigate the effects of increased vegetable intake and conventional diabetes diet on glycaemic control among type 2 diabetic patients. White-collar workers from one telecommunication company with type 2 diabetes were assigned to two treatment groups by cluster randomisation. Individuals with known type 2 diabetes and poor glycaemic control (HbA1c ≥8 g%) were eligible and a total of 84 subjects were recruited. Subjects in the intervention group (n 41) were offered to attend seminars and intensive coaching weekly to encourage them to increase raw vegetable intake. The control group (n 40) followed the conventional diet according to the guidelines of the Indonesian Society of Endocrinology. Glycated haemoglobin (HbA1c), plasma lipids, blood pressure, vegetable intake and anthropometric measurements were assessed at baseline and end line of 12 weeks intervention. A regression analysis was conducted using differences in HbA1C between baseline and 12 weeks as the dependent variable. Student's t test was conducted for the changes of biochemical indicators from baseline to end line during the period of 12 weeks intervention. Glycaemic control improved in the intervention group and mean HbA1C, fasting blood glucose and post-prandial blood glucose in the intervention group decreased significantly along with body weight, waist circumference and total cholesterol. The finding suggested that the intervention which emphasised raw vegetable intake contributed to improved glycaemic control among Indonesian adults with type 2 diabetes mellitus.

Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi

“…The HIV prevalence in the population was 11%, but the status was unknown in 13% of the participants. The mean blood pressure readings were 142 ( 26 ) mmHg systolic and 87.50 ( 15 ) mmHg diastolic. The mean HbA1c level was 10.29 (3.35).…”

“…Recent data suggest that more than two-thirds of the Malawi adult population do not consume recommended adequate amounts daily of fruits and vegetables ( 25 ). Adequate consumption of whole fruits and vegetables is essential for better BMI control and normal nutrition ( 26 ), and should be encouraged, especially among people with DM ( 26 ).…”

Restriction of Rice Portion and Pre-Meal Fruit with HbA1c Levels and Abdominal Fat for Diabetics in Malang City

“…A study on diabetes sufferers who worked at PT. Telkom Indonesia shows that increasing vegetable intake for 12 weeks by 700 grams/day can improve HbA1c levels, body weight and cholesterol levels 43 . Apart from that, studies related to increasing the consumption of dates or raisins as much as 60 g/day for 12 weeks in diabetes sufferers showed there was no difference in HbA1c levels 44 .…”

“…The practice of using a T-style plate which focuses on limiting the intake of carbohydrate sources at main meals (morning, lunch, evening) and followed by increasing fiber intake in the form of vegetables and fruit, also had an effect on reducing participants' blood sugar levels. Increasing daily intake of vegetables and fiber can improve glycemic control in diabetes mellitus sufferers 43,44 . The fiber content in natural ingredients such as vegetables and fruit have the potential to control blood sugar levels.…”

Effects of an Eating Pattern Including Colorful Fruits and Vegetables on Management of Gestational Diabetes: A Randomized Controlled Trial

“…Other studies have demonstrated that, in healthy non-pregnant subjects, increased whole berry consumption resulted in decreased postprandial glucose and increased insulin levels, suggesting improved glycemic control immediately following meals [ 15 ]. Furthermore, the addition of raw vegetables to the diets of adults with type 2 diabetes directly improved glycemic control in patients in a randomized controlled trial (RCT) [ 16 ]. This is likely because fruits and vegetables are high in metabolically active polyphenolic flavonoids that positively modulate the insulin signaling pathway, which results in reduced insulin resistance [ 17 ].…”