Effectiveness of simplified diabetes nutrition education on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus

Saman Agad Hashim; Barakatun-Nisak Mohd Yusof; Hazizi Abu Saad; Suriani Ismail; Osama Hamdy; Abbas Ali Mansour

doi:10.1016/j.clnesp.2021.07.024

Effectiveness of simplified diabetes nutrition education on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus

Clin Nutr ESPEN. 2021 Oct:45:141-149. doi: 10.1016/j.clnesp.2021.07.024. Epub 2021 Aug 3.

Authors

Saman Agad Hashim¹, Barakatun-Nisak Mohd Yusof², Hazizi Abu Saad³, Suriani Ismail⁴, Osama Hamdy⁵, Abbas Ali Mansour⁶

Affiliations

¹ Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia; Basrah Health Directorate, Ministry of Health, Basrah, 61001, Iraq. Electronic address: saman.agad.79@gmail.com.
² Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia; Institutes for Social Sciences Studies, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia. Electronic address: bnisak@upm.edu.my.
³ Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia. Electronic address: hazizi@upm.edu.my.
⁴ Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia. Electronic address: si_suriani@upm.edu.my.
⁵ Joslin Diabetes Centre, Harvard Medical School, MA, 02215, USA. Electronic address: osama.hamdy@joslin.harvard.eduand.
⁶ Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), University of Basrah, 61003, Iraq. Electronic address: abbas.mansour@fdemc.iq.

PMID: 34620310
DOI: 10.1016/j.clnesp.2021.07.024

Abstract

Background & aims: The study aimed to evaluate the effectiveness of the Simplified Diabetes Nutrition Education (SDNE) on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus (T2DM).

Methods: This a randomized controlled trial (RCT) randomized 208 patients with T2DM [mean age = 48.8 ± 11.8 years, Glycated Hemoglobin (HbA1c) = 9.5 ± 2.4%, and Body Mass Index = 28.0 ± 5.6 kg/m²] to intervention group (n = 104) or control group (n = 104). Participants in the intervention group received a weekly diabetes nutrition module based on the health belief model for 12 weeks in addition to the usual care whereas the control participants were given the usual care. We evaluated HbA1c and diabetes-related outcomes (metabolic parameters, dietary intake, and physical activity level) at baseline, 12 weeks, and 22 weeks. Health beliefs, diabetes knowledge, and health literacy were also evaluated.

Results: After 22 weeks, HbA1c improved significantly in the intervention group (-1.7%) from the baseline value, compared to the control group (+0.01%) (p < 0.001). Furthermore, the intervention group also showed better improvement in metabolic parameters than the control group (p < 0.05). Besides, dietary intake and physical activity levels improved significantly among the intervention group compared to the control group (p < 0.05). Likewise, health beliefs, diabetes knowledge, and health literacy also improved significantly in the intervention group compared to the control group (p < 0.05).

Conclusion: SDNE improves glycemic control and other diabetes-related outcomes among the intervention group compared to the control group.

Trial registration: ClinicalTrials.gov with ID: NCT04433598. Registered on 16 June 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04433598.

Keywords: Basrah; Glycated hemoglobin; Health beliefs; Health literacy; Iraq; Nutrition; Simplified education; Type 2 diabetes.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Counseling
Diabetes Mellitus, Type 2* / therapy
Glycated Hemoglobin
Glycemic Control*
Humans
Middle Aged

Substances

Glycated Hemoglobin A

Associated data

ClinicalTrials.gov/NCT04433598