Medical nutrition therapy improves clinical outcomes in asian patients with type 2 diabetes

Abstract

Aims: This prospective, pre-post design was conducted to evaluate the effect of medical nutrition therapy (MNT) to patients with type 2 diabetes on glycemic, metabolic parameters and dietary intake over a 12- week period. Methods: Subjects (n=104; age=56.4+/-9.9 years; 37% male; years of diagnosis= 6.3+/-4.9 years) treated with diet and oral tablets were given dietary advice by a dietitian for a 12 week period. Diet prescriptions were based on the MNT for adults with type 2 diabetes produced by the Malaysians Dietitians' Association. Comparisons were made on glycemic control, anthropometric measurements, lipid profiles, blood pressure and dietary intake at baseline and at the end of the study. Oral medications remained unchanged throughout the study. Results: At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-MNT results showed a significant reduction of fructosamine (311.5+/-49.5 to 297.0+/-44.0 umol/L, P< 0.001), HbA1c (7.6+/-1.2 to 7.2+/-1.1%, P< 0.001), waist circumference (90.7+/-10.2 to 89.1+/-9.8 cm, P< 0.001) and greater increment in HDLc (1.1+/-0.3 to 1.2+/-0.3 mmol/L, P< 0.05) compared to the baseline levels. At 12wk, the overall intake of carbohydrate and fat were within the recommended level. Fibre intake increased (11+/-6 to 17+/-11 g/d; P< 0.001) while dietary cholesterol reduced (249+/-71 to 222+/-71 g/d; P< 0.001) significantly. Total score of the knowledge test had increased greatly at 12wk (42+/-19 vs. 75+/-17%; P< 0.001). Conclusions: The use of MNT in diabetes management results in favourable clinical outcomes with majority of the patients able to comply with the prescribed diet.