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

J Am Diet Assoc. 2004 Dec;104(12):1805-15. doi: 10.1016/j.jada.2004.09.024.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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


  • Glycated Hemoglobin A