Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes.

Abstract

OBJECTIVES:

To examine changes in health and lifestyle indicators over 6 months in persons with type 2 diabetes mellitus receiving nutrition counseling from a registered dietitian, and to promote dietetics professionals' participation in outcomes monitoring and research.

DESIGN:

Prospective, noncontrolled descriptive study.

SUBJECTS:

Two hundred forty-four physician-referred adults with type 2 diabetes mellitus from 31 sites who received usual and customary nutrition counseling, and 83 registered dietitians.

MAIN OUTCOME MEASURES:

Glycemic control, coronary heart disease risk, self-management behaviors, and quality of life were measured at baseline, 3 months, and 6 months. Dietitians' perceptions of the study were also measured.

STATISTICAL ANALYSIS:

Repeated-measures analysis of variance, paired t test, Wilcoxon signed rank test, sign test, Spearman correlation, and chi 2 analysis were conducted.

RESULTS:

Weight and glycemic control, coronary heart disease risk, and self-management behaviors improved significantly between baseline and 3 months and baseline and 6 months. Weight, body mass index, and glycosylated hemoglobin value also improved significantly between 3 months and 6 months. Increased time and/or number of sessions with the registered dietitian were associated with weight loss and reduced glycosylated hemoglobin, fasting plasma glucose, total cholesterol, and triglyceride levels. Self-perceived health status and missed workdays were significantly improved at 6 months. Difficulty obtaining current laboratory values, lack of time, and inability to reach subjects for follow-up presented the greatest obstacles for the dietitians.

CONCLUSIONS:

Positive outcomes were observed in adults receiving nutrition intervention for type 2 diabetes. Clinical improvements were greatest between baseline and 3 months, with stabilization between 3 months and 6 months, suggesting ongoing intervention is needed to support continued clinical progress. Dietitians found participation in this state affiliate-coordinated research project rewarding.

• Authors: Christina C Lemon, Karen Lacey, Barbara Lohse, Diane Olson Hubacher, Bridget Klawitter, Mari Palta
• Journal: Journal of the American Dietetic Association (J Am Diet Assoc) Vol. 104 Issue 12 Pg. 1805-15 (Dec 2004) ISSN: 0002-8223 [Print] United States
• PMID: 15565074 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A

Topics

• Adult
• Analysis of Variance
• Counseling
• Diabetes Complications (prevention & control)
• Diabetes Mellitus, Type 2 (therapy)
• Dietetics (methods, standards)
• Evidence-Based Medicine
• Female
• Glycated Hemoglobin (analysis)
• Health Behavior
• Humans
• Longitudinal Studies
• Male
• Nutrition Therapy (methods, standards)
• Outcome and Process Assessment, Health Care
• Patient Education as Topic
• Prospective Studies
• Quality of Life
• Regression Analysis
• Time Factors
• Treatment Outcome
• Weight Loss