ABSTRACT
Non insulin dependent diabetes mellitus is a growing problem in developing countries. The majority of patients are obese and characterized by increased deposition in the trunk [central obesity]. Voluntary weight reduction initiated by patients early in the course of the disease was found to delay morbidity and mortality that accompany the disease. The aim of this study was: to achieve weight reduction and reduction in the waist/hip ratio through educating the patient to follow a special dietary regimen that supply approximately 1500 kcal/day and to practice active walking for half to one hour per day through a period of 6 months. Also to show the effect of this dietary regimen and exercise on the blood glucose level. The study included 190 patients aged from 37 up to 69 years old [47 males and 143 females] recruited from those attending the [Diabetic Care Unit] In El Menshawy General Hospital, Tanta, Egypt. Those patients were subjected to monthly health education sessions for a period of 6 months. Through these sessions the patients were advised to follow a moderately restricted caloric diet and to practice active walking for half to one hour daily. The results of the study showed that 84.73% of them were over weight and obese and 93.68% showed central deposition of fat. At the end of the study the patients showed significant reduction in their weight as shown by the reduction in body mass index from 32.48 +/- 4.73 to 30.55 +/- 4.89 in male patients and from 31.30 +/- 4.58 to 29.95 +/- 5.07 in female patients. The waist/hip ratio has been also reduced from 1.07 +/- 0.13 to 0.98 +/- 0.09 in male patients and from 1.05 +/- 0.13 to 0.96+0.09 in female patients. Also the study showed significant reduction in both fasting and postprandial blood glucose level. The restriction in B.M.I was not statistically significant among those who did not follow a regular dietary restriction. Both B.M.I and waist/hip ratio showed non-significant reduction among patients suffering from the disease more than 10 years. These findings show the importance of early dietary intervention for controlling the disease and the importance of team approach in health care of patients with chronic diseases including diabetes mellitus