Dietitian‐supported dietary intervention leads to favorable dietary changes in patients with type 2 diabetes: A randomized controlled trial

• Published in: Journal of diabetes investigation 2022-12, Vol.13 (12), p.1963-1970
• Main Authors: Kawabata, Nao, Okada, Kenta, Ando, Akihiko, Kurashina, Tomoyuki, Takahashi, Manabu, Wakabayashi, Tetsuji, Nagata, Daisuke, Arakawa, Yukiko, Haga, Atsuko, Kogure, Ayako, Chiba, Madoka, Mogi, Satsuki, Ishikawa, Shizukiyo, Ishibashi, Shun
• Format: Article
• Language: English
• Subjects: Blood pressure; Body composition; Body fat; Body mass index; Carbohydrates; Cereals; Clinical Trial; Clinical trials; Diabetes; Diabetes mellitus (non-insulin dependent); Diet; Dietary carbohydrates; Dietary services; Dietitians; Education; Energy; Energy intake; Food; Hemoglobin; Hypoglycemic agents; Intervention; Kidney diseases; Lifestyles; Metabolism; Multivariate analysis; Nutrients; Nutrition research; Proteins; Seeds
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13890

Aims/Introduction It remains to be fully elucidated whether nutrition education by dietitians can lead to specific positive changes in the food choices of patients with diabetes. Materials and Methods A total of 96 patients with type 2 diabetes and diabetic kidney disease were randomly assigned to the intensive intervention group that received nutritional education at every outpatient visit and the control group that received nutritional education once a year. The total energy intake, energy‐providing nutrients and 18 food groups were analyzed at baseline, and 1 and 2 years after the intervention in 87 patients. Furthermore, the relationship between the changes in hemoglobin A1c, body composition and changes in the total energy or energy‐producing nutrient intake was analyzed in 48 patients who did not use or change hypoglycemic agents during the study period. Results The total energy intake, carbohydrates, cereals, confections, nuts and seeds, and seasonings significantly decreased, and fish and shellfish intake significantly increased during the study period in the intensive intervention group, whereas these changes were not observed in the control group. The decrease in the total energy intake and carbohydrates after 2 years was significantly greater in the intensive intervention group than in the control group. The change in the total energy and carbohydrate intake showed a significant positive correlation with that in muscle mass. The multivariate analysis showed that the decrease in total energy intake was independently associated with that in muscle mass. Conclusion Dietitian‐supported intensive dietary intervention helps improve the diet of patients with type 2 diabetes. Frequent nutritional intervention decreased intakes of total energy and carbohydrates more significantly than conventional intervention in patients with type 2 diabetes. The decrease in the total energy intake was independently associated with that in muscle mass.