title: Dietitian-coached management in combination with annual endocrinologist follow up improves global metabolic and cardiovascular health in diabetic participants after 24 months.
abstract: This 24 month study evaluated the effect of dietitian coaching combined with minimal endocrinologist follow up on the glycemic control and cardiovascular risks of diabetic participants, compared with conventional endocrinologist follow up. Participants with type 1 or type 2 diabetes were assigned to either the control group with conventional endocrinologist follow up (C; n = 50) or the dietitian-coached group (DC; n = 51) with on-site diabetes self-management education every 3 months combined with annual endocrinologist followup. Over the 24 month intervention, weight (-0.7 vs. +2.1 kg; p = 0.04), BMI (+0.3 vs. +0.7 kg/m(2); p = 0.009), and waist circumference (-1.3 vs. +2.4 cm; p = 0.01) significantly differed between the DC and control groups. HbA(1C) dropped significantly in participants of the DC versus the control group (-0.6% vs.-0.3%; p = 0.04). This was accompanied by improved overall energy intake (-548 vs. -74 kcal/day; p = 0.04). However, no link associated glycemic control to nutrient intake or intensiveness of pharmacotherapy. Coaching by a dietitian improves glycemic control and reduces certain cardiovascular risk factors in diabetic subjects, demonstrating that a joint dietitian-endocrinologist model of care provides a convenient strategy for cardiovascular risk management in the diabetic population.
authors.affiliation: Department of Medicine, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Battista
authors.forename: Mélissa
authors.initials: M
authors.lastname: Labonté
authors.forename: Julie
authors.initials: J
authors.lastname: Ménard
authors.forename: Farrah
authors.initials: F
authors.lastname: Jean-Denis
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Houde
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Ardilouze
authors.forename: Patrice
authors.initials: P
authors.lastname: Perron
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000178:diet therapy*; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000188:drug therapy; D003927:Diet, Diabetic / Q000379:methods*; D004704:Endocrinology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000178:diet therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012648:Self Care / Q000379:methods; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents