Impact of Ramadan-focused diabetes education on hypoglycemia risk and metabolic control for patients with type 2 diabetes mellitus: A systematic review.
Tourkmani Ayla M,Abdelhay Osama,Alharbi Turki J,Bin Rsheed Abdulaziz M,Azmi Hassali Mohamed,Alrasheedy Alian A,Hassanein Mohamed M,Alotaibi Yasser K,AlShowair Abdulmajeed M,AlMadani Wedad,Alrabiah Abdulaziz M,AlBattal Saad M,Albarkah Yasser A,AlOtaibi Azzam F,Alghofaili Ibrahim A,Al Eissa Mohammed S
International journal of clinical practice
BACKGROUND:Ramadan fasting is regarded as a form of worship amongst Muslims. However, patients with a high risk of diabetic complications are advised to avoid fasting, as the practice is associated with significant impacts on several health factors for type 2 diabetic patients, including glycaemic control. Thus, a lack of focused education before Ramadan may result in negative health outcomes. AIM:To evaluate the impact of a Ramadan-focused diabetes education programme on hypoglycaemic risk and other clinical and metabolic parameters. METHODS:A systematic literature search was performed using Scopus, PubMed, Embase, and Google Scholar to identify relevant studies meeting the inclusion criteria from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and guidelines were followed when performing the search and identification of appropriate studies. RESULTS:Seventeen studies were included in this systemic review; five of them met the criteria to compile for a meta-analysis. The included studies were with various study designs, including randomised controlled trials, quasi-experimental and non-randomised studies. Overall, the results revealed a significant reduction of hypoglycemia risk (81% reduction) for fasting patients in intervention groups who received Ramadan-focused education compared with patients receiving conventional care (OR 0.19, 95% CI: 0.08-0.46). Moreover, HbA1c significantly improved amongst patients who received a Ramadan-focused diabetes education intervention, compared with those receiving conventional care. CONCLUSION:Ramadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure.
The overall plant-based diet index during pregnancy and risk of gestational diabetes mellitus: a prospective cohort study in China.
Wang Huanzhuo,Huang Li,Lin Lixia,Chen Xi,Zhong Chunrong,Li Qian,Li Nan,Gao Duan,Zhou Xuezhen,Chen Renjuan,Zhang Yu,Ye Beizhu,Hao Liping,Yang Xuefeng,Yang Nianhong,Wei Sheng
The British journal of nutrition
The high overall plant-based diet index (PDI) is considered to protect against type 2 diabetes in the general population. However, whether the PDI affects gestational diabetes mellitus (GDM) risk among pregnant women is still unclear. We evaluated the association between PDI and GDM risk based on a Chinese large prospective cohort - the Tongji Maternal and Child Health Cohort. Dietary data were collected at 13-28 weeks of pregnancy by a validated semi-quantitative FFQ. The PDI was obtained by assigning plant food groups positive scores while assigning animal food groups reverse scores. GDM was diagnosed by a 75 g 2-h oral glucose tolerance test at 24-28 weeks of gestation. Logistic regression models were fitted to estimate OR of GDM, with associated 95 % CI, comparing women in different PDI quartiles. Among the total 2099 participants, 169 (8·1 %) were diagnosed with GDM. The PDI ranged from 21·0 to 52·0 with a median of 36·0 (interquartile range (IQR) 33·0-39·0). After adjusting for social-demographic characteristics and lifestyle factors etc., the participants with the highest quartile of PDI were associated with 57 % reduced odds of GDM compared with women in the lowest quartile of PDI (adjusted OR 0·43; 95 % CI 0·24, 0·77; Pfor trend = 0·005). An IQR increment in PDI was associated with 29 % decreased odds of GDM (adjusted OR 0·71; 95 % CI 0·56, 0·90). Findings suggest that adopting a plant-based diet during pregnancy could reduce GDM risk among Chinese women, which may be valuable for dietary counselling during pregnancy.
The Effects of Dietary Education Interventions on Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis.
Kim Juri,Hur Myung-Haeng
International journal of environmental research and public health
As the incidence and prevalence of diabetes increases, intervention through dietary education is becoming more important for diabetes control. This systematic review examines the evidence for the efficacy of dietary education interventions on diabetes control. The study subjects were patients with type 2 diabetes, and the main outcome variable was glycosylated hemoglobin level (HbA1c). The target studies were randomized controlled trials. Thirty-six studies were included in the analysis, of which 33 were included in the meta-analysis. The effect size between dietary education and general interventions was -0.42 ( = 5639, MD = -0.42; 95% CI -0.53 to -0.31) and was significantly different (Z = 7.73, < 0.001). When subgroup analyses were performed following the application periods, intervention methods, and intervention contents, the mean differences in 4-6-month application, individual education, and diet-exercise-psychosocial intervention were -0.51, ( = 2742, 95% CI -0.71 to -0.32), -0.63 ( = 627, 95% CI -1.00 to -0.26), and -0.51 ( = 3244, 95% CI -0.71 to -0.32), respectively. Dietary education interventions provided for at least 3 months were highly effective in controlling HbA1c levels. Regarding the education method, individualized education was more effective, and contact or non-contact education may be applied for this. Combining diet, exercise, and psychosocial intervention is more effective than diet education alone.
The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial.
Shahabi Negar,Kolivand Mitra,Salari Nader,Abbasi Parvin
BMC endocrine disorders
BACKGROUND:Telenursing facilitates access to efficient care and acceptance and compliance with treatment at home. Given wide complications of lack of compliance with treatment in causing complications and progression of diabetes and role of the family in attending the patient, this study aimed to investigate the effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2. METHODS:This was a randomized controlled clinical trial. The study population was patients with diabetes mellitus type 2 referred to Alzhara hospital at Gilan Gharb in 2019, of which 60 individuals out of them were classified randomly into two groups of intervention and control. Eight 30-min sessions of family-centered training were held through telenursing for the intervention group. Data were gathered before and after the intervention by standard questionnaire of Mudanlo in both groups and was analyzed using SPSS software version 22. RESULTS:There was no significant difference among the two intervention and control groups before the study regarding demographic variables (p > 0.05). The scores of subscales of making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, indecisiveness for applying treatment, and total score of compliance were significantly increased after training intervention (p = 0.001). CONCLUSIONS:Results of the study indicates positive effects of performing family-centered empowerment pattern using telephone call follow-up on increasing compliance with diet regimen in patients. Therefore, it is recommended to perform family-centered patterns in health policy-makings and also hospitals and other diabetic patients.
Sustaining Effect of Intensive Nutritional Intervention Combined with Health Education on Dietary Behavior and Plasma Glucose in Type 2 Diabetes Mellitus Patients.
Fan Rui,Xu Meihong,Wang Junbo,Zhang Zhaofeng,Chen Qihe,Li Ye,Gu Jiaojiao,Cai Xiaxia,Guo Qianying,Bao Lei,Li Yong
Diabetes mellitus is very common in elderly Chinese individuals. Although nutritional intervention can provide a balanced diet, the sustaining effect on at-home dietary behavior and long-term plasma glucose control is not clear. Consequently, we conducted a long-term survey following one month of experiential nutritional intervention combined with health education. Based on the Dietary Guidelines for a Chinese Resident, we found that the food items met the recommended values, the percentages of energy provided from fat, protein, and carbohydrate were more reasonable after one year. The newly formed dietary patterns were "Healthy", "Monotonous", "Vegetarian", "Japanese", "Low energy", and "Traditional" diets. The 2h-PG of female participants as well as those favoring the "Japanese diet" decreased above 12 mmol/L. Participants who selected "Japanese" and "Healthy" diets showed an obvious reduction in FPG while the FPG of participants from Group A declined slightly. "Japanese" and "Healthy" diets also obtained the highest DDP scores, and thus can be considered suitable for T2DM treatment in China. The results of the newly formed dietary patterns, "Japanese" and "Healthy" diets, confirmed the profound efficacy of nutritional intervention combined with health education for improving dietary behavior and glycemic control although health education played a more important role. The present study is encouraging with regard to further exploration of comprehensive diabetes care.
Impacts of self-management education on glycaemic control in patients with type 2 diabetes mellitus.
Abdulah Deldar Morad,Hassan Alan Bapeer,Saadi Farsat Saeed,Mohammed Ary Habeeb
Diabetes & metabolic syndrome
OBJECTIVES:Dietary and physical activity advice have been considered to be seminal ingredients in prevention and management of type 2 diabetes mellitus. In this regard, the impacts of a three-month self-management intervention on glycemic control in patients with type 2 diabetes were examined in the present study. STUDY DESIGN:A Double-arm post-test intervention study. METHODS:In the current post-test intervention study, three two-hour educational sessions on dietary habits and physical activity designed according to Health Belief Model were presented to 16 non-complicated type 2 diabetic patients and their dietary, physical activities, and biochemical outcomes were compared to a 23 patient-control arm in Iraq in 2017. The level of physical activity was measured through International Physical Activity Questionnaire (IPAQ), dietary habits through UK Diabetes and Diet Questionnaire (UKDDQ), and biochemical indicators including HbA1c were measured after three months of program completion. RESULTS:The study showed that walking, taking vegetable, fruit, and bread were higher and taking full-fat cheese and full-fat spread was lower among experimental group significantly compared to control arm. In addition, the experimental group had a substantial higher albumin and lower urea, ALP-Phosphatase, and glucose levels in comparison with control patients. No substantial change was seen in HbA1C and no change in milk and fish products. CONCLUSIONS:The substantial positive changes in physical activity, dietary habits, and some biochemical indicators were seen following intervention completion in the experimental arm.
Diet Education as a Success Factor of Glycemia Regulation in Diabetes Patients: A Prospective Study.
Gvozdanović Zvjezdana,Farčić Nikolina,Placento Harolt,Lovrić Robert,Dujmić Željka,Jurić Ana,Miškić Blaženka,Prlić Nada
International journal of environmental research and public health
BACKGROUND:The aim of this study was to examine the effect of dietary education on glycemic control in patients with any type of diabetes at four-week and two-year follow-ups. METHODS:A two-year prospective study was conducted in three phases: before, four weeks after, and two years after an educational program. The participants were patients diagnosed with diabetes who were receiving insulin or oral hypoglycemics and who attended the Diabetes Clinic of the General County Hospital Našice, Croatia to receive their treatment. The questionnaire and educational program were created for the purpose of this study. Measurements were made (fasting blood glucose, glycated hemoglobin, body mass index, blood pressure, knowledge test) at baseline, four weeks and two years after education. RESULTS:A total of 109 participants took part in the study, of which 56 (51.4%) were on insulin therapy and 53 (48.6%) were on oral therapy, after two years, 78 (72%) subjects were followed up with. There was no control group. At the two-year follow-up, participants with insulin therapy had significantly higher glycated hemoglobin (Mann-Whitney U test, = 0.035). Significant differences were observed in fasted blood glucose (Friedman's test, = 0.001), diastolic pressure (Friedman's test, P = 0.018), and glycated hemoglobin (Wilcoxon test, < 0.001) between Phase 1 and Phase 3. CONCLUSIONS:Education has a positive effect on adherence to recommended diet and glycemia regulation in diabetes patients after four-week follow-ups. However, after two years, participants showed a decrease in adherence to recommended diet and increased glycemia.
Improving type 2 diabetes mellitus glycaemic control through lifestyle modification implementing diet intervention: a systematic review and meta-analysis.
García-Molina Laura,Lewis-Mikhael Anne-Mary,Riquelme-Gallego Blanca,Cano-Ibáñez Naomi,Oliveras-López María-Jesús,Bueno-Cavanillas Aurora
European journal of nutrition
PURPOSE:Type 2 diabetes mellitus represents a significant health problem. Many studies have reported that intensive nutritional intervention by itself or in addition to medications is the best method to improve glycaemic control in type 2 diabetes mellitus. However, in clinical practice, dietary education is not implemented as an integral part in the management of type 2 diabetes mellitus. The purpose of this systematic review and meta-analysis is to analyse the scientific evidence concerning the role of nutritional intervention in the glycaemic control of type 2 diabetes mellitus. METHODS:We searched Pubmed, Scopus, Cochrane Library and Web of Science databases from inception till May 2019 for randomised controlled trials (RCTs) that include dietary interventions in the management of patients with type 2 diabetes mellitus. RESULTS:A total of 28 studies were included. Our results demonstrated that lifestyle interventions significantly lowered glycosylated haemoglobin (HbA) levels compared to the usual care for patients with type 2 diabetes mellitus, overall weighted mean difference, WMD = - 0.51 (- 0.67, - 0.35). Strategies combining individualized and group-based activities were the most effective, WMD = - 0.95 (- 1.24, - 0.66). Most of stratified analyses did not totally resolve heterogeneity, but improvement in HbA levels has been consistently observed. CONCLUSIONS:The available evidence from RCTs shows that lifestyle intervention is more effective than the standard care regarding the glycaemic control of type 2 diabetic patients, particularly when there is a weight loss. It is time to translate this evidence to the primary health care practice. The protocol of the present systematic review was registered in PROSPERO, registration number CRD42018090469.
Development of Healthy Eating and Active Lifestyles for Diabetes, a culturally tailored diabetes self-management education and support programme for Black-British adults: A participatory research approach.
Goff Louise M,Moore Amanda P,Harding Seeromanie,Rivas Carol
Diabetic medicine : a journal of the British Diabetic Association
AIMS:To develop an evidence-based, culturally tailored, diabetes self-management education and support programme for Black-British adults, called Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), using participatory methods to engage key stakeholders in the intervention design process. METHODS:Black-British adults living with type 2 diabetes, healthcare professionals and community leaders were engaged in an intervention development study. The intervention structure, format, content and delivery were developed through three phases of participatory research: Phase 1, formative research, involved focus groups and interviews; interactive co-development workshops were conducted in Phase 2; and Phase 3 focused on materials development. RESULTS:In Phase 1, focus groups and interviews identified the importance of nurturing collectivism, a reliance on informal sources of information/advice, barriers to attending appointments associated with competing priorities of work, travel and carer commitments, and a preference for directness and simple, clear advice/messages. A priority for healthcare professionals was the intervention embedding within current primary care structures and aligning with incentivised targets/metrics. Phase 2 (workshops) highlighted key requirements: avoidance of medical settings, appropriately trained and culturally knowledgeable educators, flexible appointments, preference for verbal and visual information and avoidance of technical/medical terminology. In Phase 3 (materials development), culturally sensitive videos, short films and information booklets were developed to convey educational messages, and food photography was used to provide culturally relevant dietary advice. CONCLUSIONS:Participatory methods provide a means to understand the needs of specific communities. This approach enables the development of healthcare interventions that are sensitive to the needs of service users and providers.