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Patient Educ Couns. 2016 Aug;99(8):1368-76. doi: 10.1016/j.pec.2016.03.017. Epub 2016 Mar 19.

The diabetes nutrition education study randomized controlled trial: A comparative effectiveness study of approaches to nutrition in diabetes self-management education.

Author information

1
Division of General Internal Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Outcomes and Health Services Research, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
2
Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA.
3
Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA.
4
Department of Biostatistics, Vanderbilt University, School of Medicine, Nashville, TN, USA.
5
School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA.
6
Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA.
7
Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA. Electronic address: russell.rothman@vanderbilt.edu.

Abstract

OBJECTIVE:

To compare the effectiveness of different approaches to nutrition education in diabetes self-management education and support (DSME/S).

METHODS:

We randomized 150 adults with type 2 diabetes to either certified diabetes educator (CDE)-delivered DSME/S with carbohydrate gram counting or the modified plate method versus general health education. The primary outcome was change in HbA1C over 6 months.

RESULTS:

At 6 months, HbA1C improved within the plate method [-0.83% (-1.29, -0.33), P<0.001] and carbohydrate counting [-0.63% (-1.03, -0.18), P=0.04] groups but not the control group [P=0.34]. Change in HbA1C from baseline between the control and intervention groups was not significant at 6 months (carbohydrate counting, P=0.36; modified plate method, P=0.08). In a pre-specified subgroup analysis of patients with a baseline HbA1C 7-10%, change in HbA1C from baseline improved in the carbohydrate counting [-0.86% (-1.47, -0.26), P=0.006] and plate method groups [-0.76% (-1.33, -0.19), P=0.01] compared to controls.

CONCLUSION:

CDE-delivered DSME/S focused on carbohydrate counting or the modified plate method improved glycemic control in patients with an initial HbA1C between 7 and 10%.

PRACTICE IMPLICATIONS:

Both carbohydrate counting and the modified plate method improve glycemic control as part of DSME/S.

KEYWORDS:

Diabetes education; Numeracy; Nutrition; Type 2 diabetes

PMID:
27026388
PMCID:
PMC4931976
DOI:
10.1016/j.pec.2016.03.017
[Indexed for MEDLINE]
Free PMC Article

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