RESUMO
The present study was designed to examine the factors involved in the disappointing degree of dietary control of some maturity-onset diabetic patients and to investigate ways of improving the present method of treatment. Lack of understanding of the diet and deficiency in knowledge of the diabetic condition had been cited as the principal underlying causes of poor weight loss. These were the areas on which emphasis was placed throughout the study. Evaluation was achieved by the institution of a nutrition education programme, where patients were introduced to the causation of diabetes, its relationship to obesity and the principles of dieting. In addition, a diet was devised which was more in keeping with the socio-economic background of the patients, and presented visually in the form of a manual. Analysis of the attitudes of the patients was also attempted with the use of questionnaires. The present system of dietary treatment was found to be deficient in certain areas. In particular there was not enough emphasis on individuality and verbal instruction and there was inadequate use of the services of the dietitian. Also, appointments were not frequent enough to allow for sufficient contact between doctor and patient. Although slight improvements occurred in weight loss when more attention was paid to the diet and education, it was not significant enough to confirm these as the principal causes. However, analysis of attitudes revealed that these may play the most important role. Positive attitudes could be influenced by treatment taking on a sociological slant, with contact both on the individual level and in group sessions. Weight loss was shown to be associated with a lowering of blood glucose levels and therefore every effort should be made to control maturity-onset diabetics on diet alone before tablet therapy is introduced (AU)
