Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes.
OBJECTIVE
To examine changes in health and lifestyle indicators over 6 months in persons with type 2 diabetes mellitus receiving nutrition counseling from a registered dietitian, and to promote dietetics professionals' participation in outcomes monitoring and research.


METHODS
Prospective, noncontrolled descriptive study.


METHODS
Two hundred forty-four physician-referred adults with type 2 diabetes mellitus from 31 sites who received usual and customary nutrition counseling, and 83 registered dietitians.


METHODS
Glycemic control, coronary heart disease risk, self-management behaviors, and quality of life were measured at baseline, 3 months, and 6 months. Dietitians' perceptions of the study were also measured.


METHODS
Repeated-measures analysis of variance, paired t test, Wilcoxon signed rank test, sign test, Spearman correlation, and chi 2 analysis were conducted.


RESULTS
Weight and glycemic control, coronary heart disease risk, and self-management behaviors improved significantly between baseline and 3 months and baseline and 6 months. Weight, body mass index, and glycosylated hemoglobin value also improved significantly between 3 months and 6 months. Increased time and/or number of sessions with the registered dietitian were associated with weight loss and reduced glycosylated hemoglobin, fasting plasma glucose, total cholesterol, and triglyceride levels. Self-perceived health status and missed workdays were significantly improved at 6 months. Difficulty obtaining current laboratory values, lack of time, and inability to reach subjects for follow-up presented the greatest obstacles for the dietitians.


CONCLUSIONS
Positive outcomes were observed in adults receiving nutrition intervention for type 2 diabetes. Clinical improvements were greatest between baseline and 3 months, with stabilization between 3 months and 6 months, suggesting ongoing intervention is needed to support continued clinical progress. Dietitians found participation in this state affiliate-coordinated research project rewarding.
Lemon
Christina C
CC
Department of Human Biology, University of Wisconsin-Green Bay, WI, USA. ralemon@wisc.edu
Lacey
Karen
K
Lohse
Barbara
B
Hubacher
Diane Olson
DO
Klawitter
Bridget
B
Palta
Mari
M
D000328:Adult; D000704:Analysis of Variance; D003376:Counseling; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004046:Dietetics / Q000379:methods / Q000592:standards*; D019317:Evidence-Based Medicine; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044623:Nutrition Therapy / Q000379:methods / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D006442:Glycated Hemoglobin