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以患者为中心的营养教育改善了埃塞俄比亚北部2型糖尿病控制不佳患者的饮食行为:一项准实验研究。

Patient-centered nutrition education improved the eating behavior of persons with uncontrolled type 2 diabetes mellitus in North Ethiopia: a quasi-experimental study.

作者信息

Gebreyesus Hagos Amare, Abreha Girmatsion Fisseha, Beshirie Sintayehu Degu, Abera Merhawit Atsbha, Weldegerima Abraha Hailu, Bezabih Afework Mulugeta, Lemma Tefera Belachew, Nigatu Tsinuel Girma

机构信息

Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia.

College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

出版信息

Front Nutr. 2024 Apr 10;11:1352963. doi: 10.3389/fnut.2024.1352963. eCollection 2024.

Abstract

BACKGROUND

Improving the clinical outcome of people with type 2 diabetes mellitus by modifying their eating behavior through nutrition education is an important element of diabetes self-management. Significant data from the literature supports this idea, however in the Ethiopian setting, there is a practice gap. Therefore, the purpose of this study was to assess how patient-centered nutrition education affected the eating behavior and clinical outcomes of people with uncontrolled type 2 diabetes mellitus.

METHOD

In this quasi-experimental trial, 178 people with uncontrolled type 2 diabetes were purposely assigned to the intervention ( = 89) or control ( = 89) arm. The intervention arm was given patient-centered nutrition education, whereas the control arm received the routine care. Eating behavior and clinical outcome indicators such as HbAc, lipid profile, anthropometric indices, and blood pressure were assessed in both groups at the start and completion of the intervention. All scale variables were tested for normality and log transformed when appropriate. The baseline characteristics of the intervention and control groups were compared using the -test for continuous variables and the chi-square test for categorical variables. The effect of nutrition education was determined using a difference in differences (DID) approach. < 0.05 was established as the criterion of significance.

RESULT

Food selection (DID = 15.84, < 0.001), meal planning (DID = 31.11, < 0.001), and calorie needs (DID = 37.65, < 0.001) scores were statistically higher in the nutrition education arm. Furthermore, their overall eating behavior score (DID = 27.06, < 0.001) was statistically greater than the controls. In terms of clinical outcomes, the overall picture reveals that the intervention did not outperform over the routine care. However, in comparison to the controls, the intervention arm showed clinically significant improvement in HbA1c (DID = -0.258, = 0.485).

CONCLUSION

Patient-centered nutrition education has resulted in positive adjustments in the eating behavior of people with uncontrolled type 2 diabetes mellitus. Furthermore, it has shown a great potential for improving their glycemic control.

摘要

背景

通过营养教育改变饮食行为来改善2型糖尿病患者的临床结局是糖尿病自我管理的重要内容。文献中的大量数据支持这一观点,然而在埃塞俄比亚的实际情况中,存在实践差距。因此,本研究的目的是评估以患者为中心的营养教育如何影响未控制的2型糖尿病患者的饮食行为和临床结局。

方法

在这项准实验性试验中,178名未控制的2型糖尿病患者被特意分配到干预组(n = 89)或对照组(n = 89)。干预组接受以患者为中心的营养教育,而对照组接受常规护理。在干预开始和结束时,对两组的饮食行为和临床结局指标进行评估,如糖化血红蛋白、血脂谱、人体测量指标和血压。对所有量表变量进行正态性检验,并在适当情况下进行对数转换。使用连续变量的t检验和分类变量的卡方检验比较干预组和对照组的基线特征。使用差异差异(DID)方法确定营养教育的效果。P < 0.05被确定为显著性标准。

结果

营养教育组的食物选择(DID = 15.84,P < 0.001)、膳食计划(DID = 31.11,P < 0.001)和热量需求(DID = 37.65,P < 0.001)得分在统计学上更高。此外,他们的总体饮食行为得分(DID = 27.06,P < 0.001)在统计学上高于对照组。在临床结局方面,总体情况表明干预组并未优于常规护理组。然而,与对照组相比,干预组的糖化血红蛋白有临床显著改善(DID = -0.258,P = 0.485)。

结论

以患者为中心的营养教育使未控制的2型糖尿病患者的饮食行为得到了积极调整。此外,它在改善血糖控制方面显示出巨大潜力。

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