title: An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes.
abstract: 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.
authors.affiliation: Clinical Nutrition Center, Huadong Hospital, Fudan University, Shanghai, China. jianqins@gmail.com
authors.forename: Jianqin
authors.initials: J
authors.lastname: Sun
authors.forename: Yanfang
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiafei
authors.initials: X
authors.lastname: Chen
authors.forename: Yanqiu
authors.initials: Y
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Feng
authors.forename: Xinyi
authors.initials: X
authors.lastname: Zhang
authors.forename: Yiru
authors.initials: Y
authors.lastname: Pan
authors.forename: Ting
authors.initials: T
authors.lastname: Hu
authors.forename: Jianhua
authors.initials: J
authors.lastname: Xu
authors.forename: Luyuan
authors.initials: L
authors.lastname: Du
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Huiping
authors.initials: H
authors.lastname: Zhao
authors.forename: Rosemary E
authors.initials: RE
authors.lastname: Riley
authors.forename: Vikkie A
authors.initials: VA
authors.lastname: Mustad
mesh_terms: 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*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin