title: Effect of a nutrition education programme on clinical status and dietary behaviours of adults with type 2 diabetes in a resource-limited setting in South Africa: a randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of a participant-customised nutrition education programme on glycated Hb (HbA(1c)), blood lipids, blood pressure, BMI and dietary behaviours in patients with type 2 diabetes mellitus.
  
  
  METHODS
  A randomised controlled trial. The control group (n 41) received education materials. The intervention group (n 41) received the same education materials and participated in eight weekly (2-2·5 h) group nutrition education sessions and follow-up sessions. Outcomes were assessed at 6 and 12 months. An intention-to-treat analysis was conducted. ANCOVA compared the groups (adjustments for baseline values, age, sex and clinic).
  
  
  METHODS
  Two community health centres, Moretele sub-district (North West Province), South Africa.
  
  
  METHODS
  Adults (aged 40-70 years) with type 2 diabetes, HbA(1c) ≥8 %.
  
  
  RESULTS
  Differences in HbA(1c) (primary outcome) were -0·64 % (P=0·15) at 6 months and -0·63 % (P=0·16) at 12 months in favour of the intervention group. Starchy-food intake was significantly lower in the intervention group, 9·3 v. 10·8 servings/d (P=0·005) at 6 months and 9·9 v. 11·9 servings/d (P=0·017) at 12 months. Median energy intake was significantly lower in the intervention group at 12 months (5988 v. 6946 kJ/d, P=0·017). No significant group differences in BMI, lipid profile, blood pressure and intakes of macronutrients, vegetables and fruits were observed.
  
  
  CONCLUSIONS
  Nutrition education was not efficacious on HbA(1c); however, it improved specific dietary behaviours. Group education and hands-on activities appeared to contribute to the improvement. Optimal goal setting and self-efficacy training/assessment could benefit future nutrition education programmes for people with type 2 diabetes mellitus in resource-limited settings.
authors: 1Department of Human Nutrition, Faculty of Health Sciences,University of Pretoria,Private Bag X323,Pretoria 0001,South Africa.
authors: Jane W
authors: JW
authors: Muchiri
authors: 1Department of Human Nutrition, Faculty of Health Sciences,University of Pretoria,Private Bag X323,Pretoria 0001,South Africa.
authors: Gerda J
authors: GJ
authors: Gericke
authors: 2The School of Medicine,Department of Internal Medicine, Faculty of Health Sciences,University of Pretoria, Pretoria,South Africa.
authors: Paul
authors: P
authors: Rheeder
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012959:Socioeconomic Factors; D013019:South Africa; D016896:Treatment Outcome; D014675:Vegetables
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Clinical status; Diabetes type 2; Dietary behaviours; Nutrition education; Resource limited/poor