Objective: Diabetes mellitus requires lifelong treatment, most of which is accomplished in family and community settings. The present study was designed to identify the effectiveness of nutrition intervention provided by public dietitian on glycemic control in a community setting in China.
Methods: Two communities were selected and randomly assigned to a routine care group (59 subjects) and a public dietitian-led intervention group (58 subjects) who received diabetic nutrition management for one year. The main measures included fasting plasma glucose, HbA1c, weight, body mass index (BMI), lipid profile, and blood pressure.
Results: In the intervention group, there was significant improvement in fasting plasma glucose, HbA1c, cholesterol, and triglyceride levels relative to the control subjects (p<0.05). Over the 12-month period, there was a decrease in energy intake, including reductions in absolute amounts (grams) of protein and fat in the intervention group. The energy percent values of carbohydrate, protein, and fat were 50.7%, 17.0%, and 32.3%, respectively, at baseline and 53.0%, 17.1%, and 29.9% (within the recommended range) after the intervention. There were significant improvements in total energy, absolute amounts of fat and protein, and the energy percent values of carbohydrates and fat. In the control group, however, these values were similar before and after the intervention, and the energy percent values of fat were still above the recommended range.
Conclusions: In a community setting, a diabetes nutrition intervention led by a public dietitian significantly improved the glycemic control of type 2 diabetic patients.
目的：作为一种需要终身治疗的慢性疾病，糖尿病患者的大部分治疗时间是在 家庭和社区中度过的。本研究旨在探索公共营养师提供的营养干预对社区2型 糖尿病患者血糖控制的影响。方法：2个社区被随机分配到常规组（n=58）和 干预组（n=59），干预组接受公共营养师主导营养管理1年，评价指标包括空 腹血糖、HbA1c、BMI、体重、血脂、血压。结果：与对照组相比，干预组空 腹血糖、HbA1c、胆固醇和甘油三酯水平显著改善（p<0.05）。干预组碳水化 合物、蛋白质和脂肪供能比分别由干预前的50.7% 、17.0% 和32.3% 变为 53.0%、17.1%和29.9%，调整到糖尿病营养治疗指南推荐范围内；总能量、脂 肪和蛋白质摄入量显著降低，碳水化合物和脂肪供能比显著改善，而对照组这 些指标干预前后无显著变化，脂肪供能比仍然超出指南推荐范围。结论：公共 营养师主导的糖尿病营养干预能显著改善社区2型糖尿病患者血糖控制。.