An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes.
This study evaluated a structured and integrated intervention program on diabetes management in individuals with type 2 diabetes in Shanghai, China. Men and women with type 2 diabetes and body mass index > 23 kg/m2 were randomized into a 24-week, prospective, randomized clinical trial. The Reference Group (n=50) received diabetes education including diet and physical activity instruction only; the Intervention Group (n=100) received more intensive intervention, including diabetes education with frequent blood glucose monitoring, nutritional counseling, meal plans with diabetes-specific nutritional meal replacement, and weekly progress updates with study staff. Major study assessments were obtained at baseline, and after 12 and/or 24 weeks of intervention. The Intervention Group improved fasting blood glucose, insulin, systolic and diastolic blood pressures compared to Reference Group ( p <0.05). Importantly, HbA1c was lower ( p <0.001) in the Intervention Group at 12 weeks (-0.6 +/- 0.1%) and 24 weeks (-0.8 +/- 0.1%). Weight loss was modest, but significant differences were observed between groups ( p <0.05). Weight change from baseline after 12 and 24 weeks was -2.8 +/- 0.2% and -3.7 +/- 0.3%, respectively, in the Intervention Group vs -1.8 +/- 0.4% and -2.5 +/- 0.4% in the Reference Group. Additionally, waist and hip circumferences and waist:hip ratio decreased in the Intervention compared to the Reference Group ( p <0.05). In conclusion, this study demonstrates that Chinese men and women with type 2 diabetes following an integrated intervention program including diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal replacement, can achieve significant improvements in glycemic control and markers of cardiovascular health.
Sun
Jianqin
J
Clinical Nutrition Center, Huadong Hospital, Fudan University, Shanghai, China. jianqins@gmail.com
Wang
Yanfang
Y
Chen
Xiafei
X
Chen
Yanqiu
Y
Feng
Ying
Y
Zhang
Xinyi
X
Pan
Yiru
Y
Hu
Ting
T
Xu
Jianhua
J
Du
Luyuan
L
Zhou
Wei
W
Zhao
Huiping
H
Riley
Rosemary E
RE
Mustad
Vikkie A
VA
D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D002681:China; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000628:therapy; D003927:Diet, Diabetic / Q000379:methods; D015444:Exercise / Q000502:physiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications* / Q000378:metabolism; D010353:Patient Education as Topic; D011446:Prospective Studies; D012648:Self Care; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin