Nutricion

Nutr Res Pract. 2009 Winter; 3(4): 315–322.
Published online 2009 December 31. doi: 10.4162/nrp.2009.3.4.315
PMCID: PMC2809239
Individualized diabetes nutrition education improves compliance with diet prescription
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Abstract
This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition educationprogram was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided accordingto the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin B2, and folate per 1,000 kcal/daywere significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These resultsindicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipidconcentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.
Keywords: Nutrition education, type 2 diabetes, diet behavior, nutritional knowledge, telephone consultation

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Introduction
The prevalence of type 2 diabetes mellitus (DM) has drastically increased inrecent years in Korea. Type 2 diabetes is accompanied by complications such as dyslipidemia, hypertension and obesity (Gray et al., 1998; Hopkins et al., 1996). These complications can be prevented if glycemic control is maintained within a normal range (Genuth et al., 2003; Ko et al., 2007).
Dietary management is considered the cornerstone of glycemic control in DM patients (Lindstorm et al.,2003). Patient education including nutrition education is now accepted as an essential component of diabetic management (Jiang et al., 1999). Numerous studies with DM patients have shown the association of nutrition education with improving dietary behavior (Albarran et al., 2006; Norris et al., 2001), nutritional knowledge (Bruce et al., 2002; Lim et al., 2001) and improving clinical outcomes such aslower blood glucose and HbA1c levels (Christensen et al., 2000; Delahanty & Halford, 1993; Johnson & Valera, 2001; Miller et al., 2002) and lipid concentrations (Lee, 2007; Norris et al., 2001).
Since the diabetes educational program began in Korea in the 1970s, there were over 170 hospitals providing diabetes educational program nationwide in 2005 (Park & Ahn, 2007). Most of these...