[Adherence to a medical nutrition therapy program in pregnant women with diabetes, measured by three methods, and its association with glycemic control]

Rev Invest Clin. May-Jun 2010;62(3):235-43.
[Article in Spanish]


Introduction: The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations.

Material and methods: The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women's self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring.

Results: Women analyzed in this study (n=69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied.

Conclusions: The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.

Publication types

  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes, Gestational / blood*
  • Diabetes, Gestational / diet therapy*
  • Female
  • Humans
  • Nutrition Therapy
  • Patient Compliance / statistics & numerical data*
  • Pregnancy
  • Surveys and Questionnaires
  • Young Adult


  • Blood Glucose