A web-based tailored diet management tool (DMT) in managing diabetes patients
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Date
2013
Authors
Shamsudin, Juliana
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Diet Management Tool (DMT) is a nutrition assessment system developed by the researchers from Dietetic Programme, School of Health Sciences, Universiti Sains Malaysia (USM). The web-based system has been applied in dietary counselling for the treatment of patients with type 2 diabetes at Hospital Universiti Sains Malaysia (HUSM), replacing the standardised dietary counselling approach. This study examined the effectiveness of the dietary counselling using the DMT in the improvement of dietary management of type 2 diabetes patients in anthropometric, biochemical measurements and dietary intake pattern. A randomised controlled trial (RCT) was performed on 50 participants aged between 30-55 years old with type 2 diabetes mellitus. Participants were randomly assigned to two groups: the traditional dietary counselling (CG) (control group, n=22) and the DMT (IG) (intervention group, n=28). The IG received dietary counselling based on DMT while the CG received routine or traditional dietary counselling. The DMT consists of nutrition care modules tailored to the patients’ needs. Anthropometric (body mass index, BMI), biochemical (fasting blood sugar, estimated average glucose and HbA1c) and food pattern outcomes were measured at baseline, 3 month, 6 month and 9 month. Data was collected between June 2009 and March 2010. The nutritional status was determined using anthropometric measurement while dietary intake used a combination of dietary history and food frequency questionnaire (FFQ). Biochemical profile of participants was determined using fasting
venous blood. During the baseline study, 46.4% of IG participants and 45.5% of CG participants were classified as overweight (25-29.9 kgm-2) based on World Health Organization (WHO) classification. Meanwhile, fasting blood sugar (FBS), estimated average glucose (eAG) and HbA1c level of both groups were higher than the normal range. Intake of energy was higher as compared to mean of individual’s energy requirement. Repeated measure of ANCOVA showed that dietary counselling by the dietician for diabetic patients type 2 significantly improved glycaemic control using DMT in terms of improving HbA1c and eAG compared to control group (p<0.05). However, there were no significant changes in FBS, BMI and food pattern in both groups. In conclusion, tailored intervention approach using DMT gave positive results only in the improvement of glycaemic control of HbA1c and eAG among diabetic patients. Continuing diabetes education especially dietary counselling via tailored web-based intervention can be an important tool to maintain good metabolic control.
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Keywords
Diet Management Tool (DMT), diabetes mellitus