The diabetes nutrition education study randomized controlled trial: A comparative effectiveness study of approaches to nutrition in diabetes self-management education

PATIENT EDUCATION AND COUNSELING

卷:99

Article

Bowen, Michael E.^1,2  Cavanaugh, Kerri L.^4,5  Wolff, Kathleen⁵  Davis, Dianne⁵  Gregory, Rebecca P.⁵  Shintani, Ayumi⁶  Eden, Svetlana⁶  Wallston, Ken⁷  Elasy, Tom^3,5  Rothman, Russell L.^3,5 

[1] Univ Texas Southwestern Med Ctr, Dept Med, Div Gen Internal Med, Dallas, TX 75235 USA

[2] Univ Texas Southwestern Med Ctr, Dept Clin Sci, Div Outcomes & Hlth Serv Res, Dallas, TX 75235 USA

[3] Vanderbilt Univ, Sch Med, Dept Med, Div Gen Internal Med & Publ Hlth, Nashville, TN 37212 USA

[4] Vanderbilt Univ, Sch Med, Dept Med, Div Nephrol, Nashville, TN 37212 USA

[5] Vanderbilt Univ, Sch Med, Vanderbilt Diabet Ctr, Nashville, TN 37212 USA

[6] Vanderbilt Univ, Sch Med, Dept Biostat, Nashville, TN 37212 USA

[7] Vanderbilt Univ, Sch Nursing, Med Ctr, Nashville, TN 37240 USA

关键词: Diabetes education;    Nutrition;    Numeracy;    Type 2 diabetes;   

DOI  :  10.1016/j.pec.2016.03.017

来源: Elsevier

【 摘 要 】

Objective: To compare the effectiveness of different approaches to nutrition education in diabetes self-management education and support (DSME/S). Methods: We randomized 150 adults with type 2 diabetes to either certified diabetes educator (CDE)delivered DSME/S with carbohydrate gram counting or the modified plate method versus general health education. The primary outcome was change in HbA(1C) over 6 months. Results: At 6 months, HbA1C improved within the plate method [-0.83% (-1.29, -0.33), P < 0.001] and carbohydrate counting [-0.63% (-1.03, -0.18), P = 0.04] groups but not the control group [P = 0.34]. Change in HbA1C from baseline between the control and intervention groups was not significant at 6 months (carbohydrate counting, P = 0.36; modified plate method, P = 0.08). In a pre-specified subgroup analysis of patients with a baseline HbA(1C) 7-10%, change in HbA1C from baseline improved in the carbohydrate counting [-0.86% (-1.47, -0.26), P = 0.006] and plate method groups [-0.76% (-1.33, -0.19), P = 0.01] compared to controls. Conclusion: CDE-delivered DSME/S focused on carbohydrate counting or the modified plate method improved glycemic control in patients with an initial HbA1C between 7 and 10%. Practice implications: Both carbohydrate counting and the modified plate method improve glycemic control as part of DSME/S. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

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