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

Michael E. Bowen, Kerri L. Cavanaugh, Kathleen Wolff, Dianne Davis, Rebecca P. Gregory, Ayumi Shintani, Svetlana Eden, Ken Wallston, Tom Elasy, Russell L. Rothman

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1368-1376
Number of pages9
JournalPatient Education and Counseling
Volume99
Issue number8
DOIs
StatePublished - Aug 1 2016

Keywords

  • Diabetes education
  • Numeracy
  • Nutrition
  • Type 2 diabetes

ASJC Scopus subject areas

  • General Medicine

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