An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes

Asia Pac J Clin Nutr. 2008;17(3):514-24.

Abstract

This study evaluated a structured and integrated intervention program on diabetes management in individuals with type 2 diabetes in Shanghai, China. Men and women with type 2 diabetes and body mass index > 23 kg/m2 were randomized into a 24-week, prospective, randomized clinical trial. The Reference Group (n=50) received diabetes education including diet and physical activity instruction only; the Intervention Group (n=100) received more intensive intervention, including diabetes education with frequent blood glucose monitoring, nutritional counseling, meal plans with diabetes-specific nutritional meal replacement, and weekly progress updates with study staff. Major study assessments were obtained at baseline, and after 12 and/or 24 weeks of intervention. The Intervention Group improved fasting blood glucose, insulin, systolic and diastolic blood pressures compared to Reference Group ( p <0.05). Importantly, HbA1c was lower ( p <0.001) in the Intervention Group at 12 weeks (-0.6 +/- 0.1%) and 24 weeks (-0.8 +/- 0.1%). Weight loss was modest, but significant differences were observed between groups ( p <0.05). Weight change from baseline after 12 and 24 weeks was -2.8 +/- 0.2% and -3.7 +/- 0.3%, respectively, in the Intervention Group vs -1.8 +/- 0.4% and -2.5 +/- 0.4% in the Reference Group. Additionally, waist and hip circumferences and waist:hip ratio decreased in the Intervention compared to the Reference Group ( p <0.05). In conclusion, this study demonstrates that Chinese men and women with type 2 diabetes following an integrated intervention program including diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal replacement, can achieve significant improvements in glycemic control and markers of cardiovascular health.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring
  • China
  • Counseling
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes Mellitus, Type 2 / therapy
  • Diet, Diabetic* / methods
  • Exercise / physiology
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Insulin / blood
  • Male
  • Middle Aged
  • Overweight / complications*
  • Overweight / metabolism
  • Patient Education as Topic*
  • Prospective Studies
  • Self Care
  • Weight Loss / physiology*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin