Effectiveness of an adapted diabetes nutrition education program on clinical status, dietary behaviors and behavior mediators in adults with type 2 diabetes : a randomized controlled trial

dc.contributor.authorMuchiri, Jane Wanjiku
dc.contributor.authorGericke, Gerda J.
dc.contributor.authorRheeder, Paul
dc.contributor.emailjane.muchiri@up.ac.zaen_US
dc.date.accessioned2022-11-16T06:21:45Z
dc.date.available2022-11-16T06:21:45Z
dc.date.issued2021-06
dc.description.abstractPURPOSE : This study evaluated the effectiveness of an adapted social-cognitive theory underpinned diabetes nutrition education program (NEP) on: clinical (HbA1c, BMI, blood lipids, blood pressure) and selected dietary behaviors (starchy foods and energy intake, vegetables and fruit intake) and behavior mediators (knowledge and diabetes management self-efficacy) in patients with type 2 diabetes mellitus (T2DM). METHODS : A tertiary hospital outpatient adults (40–70 years) with poorly controlled (HbA1c ≥ 8 %) T2DM were randomized to either intervention group (n = 39: NEP, 7-monthly group education sessions, bi-monthly follow-up sessions, 15-minute individual session, workbook + education materials) or control group (n = 38: education materials only). NEP aimed to improve clinical status through improved dietary behaviors and behavior mediators. Outcomes and changes in diabetes medication were assessed at six and 12 months. Intention-to-treat analysis was conducted. ANCOVA compared the groups (baseline values, age, sex adjustments). RESULTS : Forty-eight (62.3 %) participants completed the study. Intervention group compared to the control group had lower (-0.53 %), clinically meaningful HbA1c (primary outcome) at 6 months, albeit not sustained at 12 months. Compared to the control group, the intervention group had significantly lower: (i) systolic blood pressure at six and 12 months (ii) diastolic pressure at 12 months, (iii) energy intake at six-months, (iv) up-titration of insulin at six and 12 months and higher diabetes knowledge scores at six months. CONCLUSIONS : NEP had limited effects on HbA1c, targeted dietary behaviors and behavior mediators but showed positive effects on blood pressure. The NEP health cost savings potential supports the need for improving program participation. TRIAL REGISTRATION : ClinicalTrials.gov. number NCT03334773; 7 November 2017 retrospectively registered.en_US
dc.description.departmentHuman Nutritionen_US
dc.description.departmentInternal Medicineen_US
dc.description.librarianhj2022en_US
dc.description.sponsorshipThe South African Sugar Association.en_US
dc.description.urihttps://www.springer.com/journal/40200en_US
dc.identifier.citationMuchiri, J.W., Gericke, G.J. & Rheeder, P. Effectiveness of an adapted diabetes nutrition education program on clinical status, dietary behaviors and behavior mediators in adults with type 2 diabetes: a randomized controlled trial. Journal of Diabetes and Metabolic Disorders 20, 293–306 (2021). https://doi.org/10.1007/s40200-021-00744-z.en_US
dc.identifier.issn2251-6581 (online)
dc.identifier.other10.1007/s40200-021-00744-z
dc.identifier.urihttps://repository.up.ac.za/handle/2263/88300
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.rights© Springer Nature Switzerland AG 2021. The original publication is available at : https://www.springer.com/journal/40200.en_US
dc.subjectType 2 diabetes mellitus (T2DM)en_US
dc.subjectNutrition education program (NEP)en_US
dc.subjectRandomized controlled trial (RCT)en_US
dc.subjectSouth Africa (SA)en_US
dc.subjectDietary behaviorsen_US
dc.subjectDiabetes management self‐efficacyen_US
dc.subjectDiabetes knowledgeen_US
dc.subject.otherHealth sciences articles SDG-03
dc.subject.otherSDG-03: Good health and well-being
dc.titleEffectiveness of an adapted diabetes nutrition education program on clinical status, dietary behaviors and behavior mediators in adults with type 2 diabetes : a randomized controlled trialen_US
dc.typePostprint Articleen_US

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