Effect of a nutrition education programme on clinical status and dietary behaviours of adults with type 2 diabetes in a resource-limited setting in South Africa: a randomised controlled trial

• Published in: Public health nutrition Vol. 19; no. 1; pp. 142 - 155
• Main Authors: Muchiri, Jane W, Gericke, Gerda J, Rheeder, Paul
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-01-2016
• Subjects: Adult; Aged; Blood Glucose - metabolism; Blood Pressure; Body Mass Index; Clinics; Counseling; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - therapy; Education; Energy Intake; Feeding Behavior; Female; Follow-Up Studies; Fruit; Glycated Hemoglobin - metabolism; Health Behavior; Health Education; Humans; Intervention; Interventions; Lipids; Male; Middle Aged; Nutrition; Nutrition education; Patient Education as Topic; Professionals; Research Papers; Socioeconomic Factors; South Africa; Treatment Outcome; Vegetables; United States > US; South Africa; Africa; Resource limited/poor; Clinical status; Dietary behaviours; Nutrition education; Diabetes type 2
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980015000956

To evaluate the effect of a participant-customised nutrition education programme on glycated Hb (HbA(1c)), blood lipids, blood pressure, BMI and dietary behaviours in patients with type 2 diabetes mellitus.
A randomised controlled trial. The control group (n 41) received education materials. The intervention group (n 41) received the same education materials and participated in eight weekly (2-2·5 h) group nutrition education sessions and follow-up sessions. Outcomes were assessed at 6 and 12 months. An intention-to-treat analysis was conducted. ANCOVA compared the groups (adjustments for baseline values, age, sex and clinic).
Two community health centres, Moretele sub-district (North West Province), South Africa.
Adults (aged 40-70 years) with type 2 diabetes, HbA(1c) ≥8 %.
Differences in HbA(1c) (primary outcome) were -0·64 % (P=0·15) at 6 months and -0·63 % (P=0·16) at 12 months in favour of the intervention group. Starchy-food intake was significantly lower in the intervention group, 9·3 v. 10·8 servings/d (P=0·005) at 6 months and 9·9 v. 11·9 servings/d (P=0·017) at 12 months. Median energy intake was significantly lower in the intervention group at 12 months (5988 v. 6946 kJ/d, P=0·017). No significant group differences in BMI, lipid profile, blood pressure and intakes of macronutrients, vegetables and fruits were observed.
Nutrition education was not efficacious on HbA(1c); however, it improved specific dietary behaviours. Group education and hands-on activities appeared to contribute to the improvement. Optimal goal setting and self-efficacy training/assessment could benefit future nutrition education programmes for people with type 2 diabetes mellitus in resource-limited settings.