Prospective Randomized Controlled Trial to Evaluate Effectiveness of Registered Dietitian–Led Diabetes Management on Glycemic and Diet Control in a Primary Care Setting in Taiwan  

Oleh:

Meng-Chuan, Huang ; Chih-Cheng, Hsu

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 33 no. 02 (Feb. 2010), page 233-239.
Topik: DIABETES; DIABETES MELLITUS; Dietitian–Led Diabetes; Glycemic; Diet Control; Primary Care Setting

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2010.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE : In this randomized controlled trial we evaluated the effect of registered dietitian–led management of diabetes on glycemic control and macronutrient intake in type 2 diabetic patients in primary care clinics in Taiwan and studied the association between changes in macronutrient intake and glycemic measures. RESEARCH DESIGN AND METHODS : We recruited 154 adult patients with type 2 diabetes and randomly assigned them to a routine care control group (n = 79) or a registered dietitian–led intervention group (n = 75) who received on-site diabetic self-management education every 3 months over 12 months. RESULTS : Over the 1-year period, neither the intervention group (n = 75) nor the control group (n = 79) had significant changes in A1C, whereas the intervention patients with poorly controlled baseline A1C (=7%) (n = 56) had significantly greater improvements in A1C and fasting plasma glucose than the control subjects (n = 60) (-0.7 vs. -0.2%, P = 0.034; -13.4 vs. 16.9 mg/dl, P = 0.007) during the same period. We also found significant net intervention-control group differences in overall energy intake (-229.06 ± 309.16 vs. 56.10 ± 309.41 kcal/day) and carbohydrate intake (-31.24 ± 61.53 vs. 7.15 ± 54.09 g/day) (P < 0.001) in patients with poorly controlled A1C. Multivariable adjusted modeling revealed an independent association between changes in carbohydrate intake and A1C in the intervention group (n = 56; ß = 0.10, SEM = 0.033, P = 0.004). CONCLUSIONS : On-site registered dietitian–led management of diabetes can improve glycemic control in patients with poorly managed type 2 diabetes in primary care clinics in Taiwan. A reduction in carbohydrate intake may improve glycemic status.

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