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 language | English (US) |
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Pages (from-to) | 1368-1376 |
Number of pages | 9 |
Journal | Patient Education and Counseling |
Volume | 99 |
Issue number | 8 |
DOIs | |
State | Published - Aug 1 2016 |
Keywords
- Diabetes education
- Numeracy
- Nutrition
- Type 2 diabetes
ASJC Scopus subject areas
- General Medicine