Influence of individualized diet on glycemic control and pregnancy outcomes in patients with gestational diabetes / 中国基层医药

Objective To explore and analyze the influence of individual diet on glycemic control and pregnancy outcomes in patients with gestational diabetes .Methods 80 patients with gestational diabetes were selected as study objects , and according to the time sequence they were divided into control group and observation group,40 cases in each group .The control group was only given routine therapy , the observation group received individualized diet control based on the routine therapy .The blood sugar change and pregnancy outcome were compared between the two groups .Results Compared with before treatment ,the fasting plasma glucose ,postprandial 1h blood sugar,postprandial 2h blood sugar,IRI in the two groups after treatment were decreased ,postprandial 1h insulin value,postprandial 2h insulin value,IFI in the two groups were increased .And those indicators in the observa-tion group were improved more significantly compared with the control group ( t =5.34,5.13,5.24,5.53,5.24, 5.56,5.41,all P <0.05).The incidence rates of premature,macrosomia and cesarean section of the observation group were lower than those of the control group (2.50％vs.10.00％、2.50％vs.10.00％、5.00％vs.22.5％),the differences were statistically significant (χ2 =4.87,5.12,4.87,all P<0.05).The incidence rates of fetal distress, premature rupture of membranes , perinatal death between the two groups had no statistically significant differences (χ2 =0.90,0.77,0.56,all P>0.05).Conclusion Conventional treatment combined with individualized diet can delay the progression of the pregnant women gestational diabetes,lower blood sugar level,improve the pregnancy outcome.

Practical Diet Education for Patients with Type 2 Diabetes: Tips for Physicians / 임상당뇨병

Comprehensive education is the cornerstone of diabetes management. However, in Korea, diabetes education is constrained by short office visits. This article intends to introduce various educational strategies, particularly regarding diet style modification, that can be employed in the time-limited outpatient setting to improve diabetes management. Instructing patients to reduce their intake of carbohydrates, the predominant nutrient consumed in a traditional Korean diet, may be beneficial. The use of novel educational technologies or the introduction of new healthy diet plans may also help.

Hábitos alimentares e perfil de ingestão de energia e nutrientes de crianças eadolescentes com diabetes mellitus tipo 1 / Eating habits and energy and nutrient intake profile in children and adolescents with type 1 diabetes mellitus

Introdução: a adoção de hábitos alimentares adequados, fundamental para o controlemetabólico da criança com diabetes mellitus tipo 1 (DM1), necessita do envolvimentoe participação efetiva da família e pode implicar mudanças nos padrões alimentares jáestabelecidos. Objetivo: avaliar o perfil alimentar de crianças e adolescentes com DM1e sua adequação às recomendações atuais. Casuística e métodos: foram estudadas146 pessoas com idade entre sete e 19 anos e no mínimo um ano de diagnóstico deDM1, atendidos na Divisão de Endocrinologia Pediátrica do Hospital das Clínicas daUniversidade Federal de Minas Gerais. A dieta foi avaliada por meio de questionárioquantitativo de frequência alimentar, testado e validado previamente em projeto-piloto.Resultados: o percentual médio de calorias ingeridas como proteínas e gordurapoli-insaturada estava dentro das recomendações adotadas; o de gordura saturadae colesterol superou a recomendação em toda a população estudada. A ingestão degordura monoinsaturada e a de carboidratos nos indivíduos com até 14 anos de idadenão atingiu a recomendação adotada. Adolescentes entre 15 e 19 anos ingeriram altopercentual de calorias provenientes de carboidratos, enquanto as crianças entre sete e10 anos de idade ingeriram mais gorduras e proteínas. Os adolescentes de 15 a 19 anosapresentaram hábitos alimentares mais inadequados. Conclusão: constituem motivode preocupação a dieta com perfil lipídico insatisfatório e hábitos alimentares inapropriados,inadequações nutricionais que contribuem para o mau controle de DM1.

Introduction: adopting proper eating habits is crucial for the metabolic control of diabetesmellitus type 1 (DM1) in children and requires the involvement and effective participationof the family implying in changes in established eating patterns. Objective: toevaluate the dietary profile of children and adolescents with DM1 and their adaptation tocurrent recommendations. Patients and methods: we studied 146 individuals aged betweenseven and 19 years old with at least one year of DM1 diagnosis and treated at theDivision of Pediatric Endocrinology of the General Hospital, Federal University of MinasGerais. The diet was assessed by a quantitative food frequency questionnaire, previouslytested and validated in a pilot project. Results: the average percentage of ingestedcalories as protein and polyunsaturated fat was within the adopted recommendations;that of saturated fat and cholesterol exceeded the recommendation in the entire studypopulation. The monounsaturated fat and carbohydrates intake in individuals under 14years of age did not reach the adopted recommendation. Adolescents between 15 and19 years old ingested a high percentage of calories from carbohydrates while childrenbetween seven and ten years old ingested more fat and protein. Adolescents between15 and 19 years old presented the most inadequate eating habits. Conclusion: a diet with poor lipid profile, inappropriate eating habits, andnutritional inadequacies that contribute to poor controlof DM1 are of concern.

Small Rice Bowl-Based Meal Plan for Energy and Marcronutrient Intake in Korean Men with Type 2 Diabetes: A Pilot Study

BACKGROUND: Koreans eat rice, which is usually served in a rice bowl. We investigated the effect of a meal plan using small rice bowls on the total energy intake (TEI) and the marcronutrient intake in Korean men with type 2 diabetes. METHODS: A total of 62 men with type 2 diabetes were divided by body mass index (BMI) (normal weight [NW], BMI or =25 kg/m2) and proportions of carbohydrate intake to TEI (PCI) (low carbohydrate intake [LC], or =55% and 60%). The 3-day dietary records were analyzed for TEI and proportions of macronutrients, before and 2 weeks after a small-sized (300 mL) rice bowl based education was given. RESULTS: There were no significant differences in the age and BMI within the sub-groups by BMI and PCI groups. In baseline, the ratio of TEI to recommended total energy intake (RTR) of OW and OB were higher than that of NW. The PCI of HC was higher than that of LC and alcohol intake of HC was lower than that of LC. After education, the reduction of RTREI in OB was higher than that in OW and NW. The reduction of PCI in HC was higher than that of LC. CONCLUSION: A small rice bowl based meal plan was effective for the reduction of energy intake and control of marcronutrient intake in Korean obese men with type 2 diabetes consuming a high carbohydrate diet.

Associação entre fatores nutricionais e o controle glicêmico de crianças e adolescentes com diabetes melito tipo 1 / Relationship between nutrition factors and glycemic control in children and adolescents with type 1 diabetes mellitus

OBJETIVO: Identificar fatores nutricionais que influenciaram o controle glicêmico da população estudada. SUJEITOS E MÉTODOS: Participaram do estudo 146 crianças e adolescentes, entre 7 e 19 anos de idade, atendidos na Divisão de Endocrinologia Pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais. A dieta foi avaliada por meio de Questionário Quantitativo de Frequência Alimentar validado e adaptado à população estudada. O controle glicêmico foi avaliado como bom, regular ou ruim a partir da média de dois resultados de HbA1c dos seis meses anteriores à data da avaliação dietética. RESULTADOS: Dietas com maior teor de proteína, menor teor de gordura saturada e com índice glicêmico (IG) e carga glicêmica (CG) mais baixos afetaram positivamente o controle glicêmico dos indivíduos estudados. O hábito de consumir sacarose e merenda gratuita influenciou negativamente o controle glicêmico. CONCLUSÃO: O consumo de dietas nutricionalmente adequadas e de baixo IG/CG favoreceu o controle glicêmico da população estudada.

OBJECTIVE: To identify nutritional factors that affected the glycemic control of the studied population. SUBJECTS AND METHODS: One hundred forty-six children and adolescents, aged 7 to 19 years, followed-up at the Division of Pediatric Endocrinology of the Hospital das Clínicas da Universidade Federal de Minas Gerais participated in the study.The diet of each participant was evaluated by means of a Quantitative Food Frequency Questionnaire, previously validated in a pilot-project. Glycemic control was assessed through the average of HbA1c results obtained six months prior to date of diet evaluation. RESULTS: Diets with high protein content, less saturated fats, and lower glycemic index (GI)/glycemic load (GL) had a positive effect on glycemic control. The consumption of sucrose and of free snacks provided by the school had a negative influence on glycemic control. CONCLUSION: The consumption of nutritionally adequate and low GI/GL diets favored glycemic control of the studied population.

The Small Rice Bowl-Based Meal Plan was Effective at Reducing Dietary Energy Intake, Body Weight, and Blood Glucose Levels in Korean Women with Type 2 Diabetes Mellitus / 당뇨병

BACKGROUND: The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels. METHODS: Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records. RESULTS: Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups. CONCLUSION: The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.

Small Rice Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Weight, Glucose and Lipid Control in Obese Type 2 Diabetic Patients / 당뇨병

BACKGROUND: The Korean National Health and Nutrition Examination Surveys reported 65% of daily energy intake (EI) as carbohydrate (CHO) in the Korean population and main source of CHO was cooked rice. We used a standardized-small sized rice bowl for diet education and investigated its effectiveness on body weight, glucose and lipid, compared to the conventional food exchange system in type 2 diabetes obese women. METHODS: Type 2 diabetic women with body mass index > or = 23 kg/m2 were randomly assigned to small rice bowl-based meal plan (BM) and food exchange-based meal plan (ExM) group. Both groups were asked to reduce their EI by 500 kcal/day for 12 weeks. The macronutrient composition was instructed: 55 to 60% of EI as CHO, 15 to 20% as protein, and 20 to 25% as fat. BM group received only a simple instruction for application of the rice bowl. Nutrient intake was estimated with the 3-day dietary records. RESULTS: Finally, 44 subjects finished the study. The percent reduction of body weight was significant both BM group (-5.1 +/- 2.6%) and ExM group (-4.8 +/- 2.8%) after 12 weeks (P < 0.001) but there was no difference between the groups. There was no difference in the proportional change of CHO, protein and fat in EI between the groups. Additionally, the change of HbA1c and low density lipoprotein-cholesterol were not significantly different between the two groups. CONCLUSION: The BM group was as effective as ExM for body weight and glucose control in type 2 diabetes obese women.

The Relationship among Clinical Competence on Diabetic Diet Education Using Standardized Patients, Self-efficacy, Communication, Learning Satisfaction, and Professional Values of Nursing Students / 성인간호학회지

PURPOSE: The purpose of this study is to identify the relationship among clinical competence of diabetic diet education on standardized patients, self-efficacy, communication skill, learning satisfaction, and professional values of nursing students. METHODS: The present study was a descriptive research. The participants were 144 junior nursing students in a university. The clinical competence on diabetic diet education was assessed by trained evaluators when nursing students performed diabetic diet education using the standardized patients. The students' self-efficacy, communication skill, professional values, and learning satisfaction were measured by themselves using the questionnaires. RESULTS: The clinical competence on diabetic diet education showed positive correlations with communication skill and learning satisfaction, while the competence was not correlated to self-efficacy and professional values. CONCLUSION: The results of this study suggest that clinical competence on diabetic diet education may be more related to communication skills and learning satisfaction than self-efficacy and professional values. Promoting communication skills and learning satisfaction using a standardized patient may increase nursing students' competence on diabetic diet education.

The Effects of Small Sized Rice Bowl on Carbohydrate Intake and Dietary Patterns in Women with Type 2 Diabetes / 당뇨병

BACKGROUND: The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. METHODS: A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] or = 25 kg/m2; n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. RESULTS: After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes were found in all three groups, which complies with Korean Diabetes Association recommendations. The protein proportion of TEI significantly increased only in the OW group. Body weight decreased both in the OW and OB groups. CONCLUSION: A short-term, small-rice-bowl-based meal plan was effective for body weight control and macronutrient balance in overweight or obese women in Korea with type 2 diabetes.

Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients / 당뇨병

BACKGROUND: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.

Association Between Volume of Bowls and the Dietary Intakes in Subjects with Type 2 Diabetes / 당뇨병

BACKGROUND: The results of previous studies suggest that portion size is a major factor dictating dietary energy intake. We investigated the relationship between frequencies of rice meals, bowl volumes, and dietary energy intake in a sample of patients with type 2 diabetes. METHODS: A total of 203 type 2 diabetes patients were enrolled in the study. A one-week food diary was collected from each patient and used to assess the types of meal consumed as well as the context of consumption. The volumes of the eating vessels (rice, soup and side dish bowls) used by each patient were obtained by comparisons to measuring cylinders, and dietary energy and macronutrient intake were estimated for each patient by consulting three-day dietary records. RESULTS: The mean age of the 203 subjects (male: 76, female: 127) was 53.9 +/- 9.1 years and the average body mass index (BMI) was 25.6 +/- 4.2 kg/m2. Among the subjects who ate three times per day, 96.4% consumed rice more than twice out of three meals. The median volume of rice bowls used by patients was 350 cc, of soup bowls was 530 cc and of side dish bowls was 260 cc. Portion size, as estimated by rice bowl volume, was not associated with BMI. Male subjects tended to eat out of larger rice and soup bowls (P < 0.001). Portion size was correlated with energy intake from rice (P = 0.021), but not with total energy intake (kcal/kg/day), especially in male subjects. CONCLUSION: Portion size of rice bowl was correlated with energy intake from rice, but not with total energy intake in male subjects with type 2 diabetes. To design effective meal planning methods for patients with type 2 diabetes, further prospective studies are warranted to investigate causative relationships between portion size andmetabolic conditions as well as variation by gender.

Effects of cooking practice education for diabetics aged over 60 on their nutrient intake and blood glucose control / 中华全科医师杂志

Objective To study the effects of cooking practice education on their status of nutrient intake and blood glucose control in patients with type 2 diabetes mellitus (T2DM) over 60 years old.Methods Four-hour cooking practice education lecture was offered per month for 57 patients with T2DM over 60-year old based on balance diet and food exchange list,with features including requiring patients joining the lecture with their family members together,demonstration of raw and fresh dietary materials and cooked food,choice of food to eat by the patients themselves according to their own dietary regimen.Sixty patients with T2DM who were only educated by outpatient department of nutrition for 35 minutes were selected as control.After twelve months of education,indices such as scores of awareness of knowledge of food exchange list,status of nutrient intake and blood glucose control,and so on,were compared between the two groups to evaluate the effects of cooking practice education.Results After 12- month education,score of knowledge of food exchange list in the experiment group increased significantly,as compared to that in the control group.Intake of energy [(6304?826) kJ] and fat [(46?6) g] decreased significantly in the experimental group [(6921?860) kJ and (63?9) g,respectively],and fasting blood glucose [(7.1?0.8) mmol/L],postprandial blood glucose [(11.2?1.1) mmol/L] and glycosylated hemoglobin A1c [(6.2?0.5)%] were decreased significantly,as compared to those in the control group [(7.8?0.9) mmol/L,(12.4?1.2) mmol/L,and (6.5?0.7)%)],respectively.Conclusions Cooking practice education is effective to correctly use diet regimen and improve status of nutrient intake and control of blood glucoses for over-60-year patients with T2DM.