Effects of diabetes nutrition education on glycemic control and diabetes-related outcomes among individuals with Type 2 Diabetes Mellitus at selected health clinics in Padang, Indonesia
While structured nutrition education is vital for patients with Type 2 Diabetes (T2DM), comprehensive studies that look into the patient and the nutritionist's needs in developing and evaluating the appropriate nutrition education tools in Indonesia are scarce. Thus, this study was conducted...
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| Format: | Thesis |
| Language: | English English |
| Published: |
2022
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/111588/1/FPSK%28p%29%202022%2043%20-%20IR.pdf |
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| Summary: | While structured nutrition education is vital for patients with Type 2 Diabetes
(T2DM), comprehensive studies that look into the patient and the nutritionist's
needs in developing and evaluating the appropriate nutrition education tools in
Indonesia are scarce. Thus, this study was conducted to determine the effects
of diabetes nutrition education (DNE) on glycemic control and other-related
outcomes among patients with T2DM at selected health clinics in Padang,
Indonesia. The study consisted of three phases based on Generalized Model for
Program Planning and during the COVID-19. Phase I involved a cross-sectional
need assessment survey with nutritionists (n=48) and patients (n=179) in
Padang City. Phase II focused on developing and assessing DNE modules and
materials based on the Health Belief Model (HBM). Phase III was a cluster
randomized controlled study involving eight Public Health Centers (PHC), with
150 participants in the Intervention Group (IG; N=75) and Control Group (CG;
N=75). The IG received a structured 7 sessions of DNE delivered by nutritionists
at an individual level for every month within the first 3 months and came for
follow-up at 6 months. Participants in the CG continued attending the regular
sessions delivered by the nutritionists for the same study period. Primary
outcomes measure included glycemic control (HbA1c and fasting blood glucose
(FBG)), and secondary outcomes were diabetes-related, which included the
nutritional status (anthropometry, blood pressure, dietary intake), knowledgeattitude
practice (KAP) regarding diabetes management, and quality of life
(QoL). The Phase I study identified leaflets (93.8%) as the primary material for
nutrition education. The nutritionists (52.1%) were also concerned that their
patients were reluctant to attend the education sessions and about 20.8% of
them reported that the current materials were insufficient to attract interest,
which highlighted the need to develop the DNE. In fact,
nearly half of patients with T2DM (42.3%) did not attend the nutrition education session since their
doctor did not refer them to the nutritionists.
In Phase III, Baseline characteristics between the groups were comparable
except for fiber intake and knowledge component in KAP, which was better in
IG. At the end of 6 months, like CG, participants in IG did not improve their
HbA1c, FBG, anthropometric data, and QoL, which were no different from CG.
Nonetheless, a more significant improvement was observed in IG than CG for
diastolic blood pressure (BP), level of KAP regarding Diabetes Management,
and the component of dietary intake (energy and dietary carbohydrate, fat, and
fiber). Concurrently, participants in CG achieved a substantial systolic BP
improvement compared to IG participant. In conclusion, the study highlighted the
need to have structured diabetes nutrition education for T2DM patients from
patients themselves and nutritionists, which led to the DNE development. The
delivery of DNE had shown improvement in diastolic BP and KAP regarding
Diabetes Management and dietary intake. The patients and the nutritionists well
accepted the DNE. |
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