Abstract
Background
Prior studies have provided evidence that lifestyle change prevents or delays the
occurrence of type 2 diabetes mellitus. The challenge is to translate research evidence
for type 2 diabetes mellitus prevention into health care settings.
Objective
We investigated the effect of medical nutrition therapy (MNT) compared with usual
care on fasting plasma glucose values, glycated hemoglobin (HbA1c), serum lipid levels,
and Diabetes Risk Score, from baseline to the end of a 12-week intervention in overweight
or obese adults with prediabetes.
Design
Prospective, randomized, parallel group study of 76 adults with impaired fasting plasma
glucose or an HbA1c of 5.7% to 6.4%, recruited between April 2010 and May 2011 who
completed a 12-week intervention period.
Main outcome measures
The primary outcome measure was fasting plasma glucose. Secondary outcome measures
were HbA1c, serum lipid levels, and Diabetes Risk Score.
Statistical analyses
A factorial repeated measures analysis of variance was used to make comparisons between
the two groups (the MNT and usual care groups) and two measures of time (baseline
and 12 weeks postintervention). Data analysis was performed using the Statistical
Package for the Social Sciences (release 19.0, 2010, SPSS Inc).
Results
There was a significant interaction for group assignment and HbA1c (P=0.01), with the MNT group experiencing significantly lower HbA1c levels than the
usual care group (5.79% vs 6.01%) after the 12-week intervention. There was a significant
interaction for group assignment and Diabetes Risk Score (P=0.001). Diabetes Risk Score for the MNT group decreased from 17.54±3.69 to 15.31±3.79
compared with the usual care group score, which went from 17.23±4.69 to 16.83±4.73.
Regardless of group assignment, both groups experienced a reduction in total cholesterol
(P=0.01) and low-density lipoprotein cholesterol (P=0.04) level.
Conclusions
The results demonstrate that individualized MNT is effective in decreasing HbA1c level
in patients diagnosed with prediabetes.
Keywords
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Biography
A. R. Parker is a research dietitian and a certified diabetes educator, Anaheim Clinical Trials, Anaheim, CA.
Biography
P. J. Winkle is a physician, Anaheim Clinical Trials, Anaheim, CA.
Biography
L. Byham-Gray is an associate professor, Department of Nutritional Sciences, and director, Masters in Clinical Nutrition Program, School of Health-Related Professions, Rutgers University, formerly known as the University of Medicine and Dentistry of New Jersey, Stratford.
Biography
R. Denmark is an associate professor, Interdisciplinary Studies, Rutgers University, formerly known as the University of Medicine and Dentistry of New Jersey, Stratford.
Article info
Publication history
Published online: September 11, 2014
Accepted:
June 30,
2014
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by a Diabetes Care and Education Dietetic Practice Group/Academy of Nutrition and Dietetics Foundation Diabetes MNT Outcomes Research award. Anaheim Clinical Trials sponsored the trial because subjects were seen at the research site.
Identification
Copyright
© 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
