title: [Adherence to a medical nutrition therapy program in pregnant women with diabetes, measured by three methods, and its association with glycemic control].
abstract: BACKGROUND
  The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations.
  
  
  METHODS
  The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women's self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring.
  
  
  RESULTS
  Women analyzed in this study (n=69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied.
  
  
  CONCLUSIONS
  The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.
authors.affiliation: Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Lomas de Virreyes, DF México.
authors.forename: Margie
authors.initials: M
authors.lastname: Balas-Nakash
authors.forename: Ameyalli
authors.initials: A
authors.lastname: Rodríguez-Cano
authors.forename: Cinthya
authors.initials: C
authors.lastname: Muñoz-Manrique
authors.forename: Paulina
authors.initials: P
authors.lastname: Vásquez-Peña
authors.forename: Otilia
authors.initials: O
authors.lastname: Perichart-Perera
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000178:diet therapy*; D016640:Diabetes, Gestational / Q000097:blood* / Q000178:diet therapy*; D005260:Female; D006801:Humans; D044623:Nutrition Therapy; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D001786:Blood Glucose