Effects Of The Glycemic-load-based Food Exchange Serving On The Diet-education Of Type 2 Diabetes

Objective To explore the effects of the glycemic-load-based food exchange serving on the diet education for Type 2 diabetes.Methods 72 cases of Type 2 diabetic outpatients were selected from a Grade 3(best) hospital of Shanghai.Then they were randomly divided into a test group and a control group, each with 36 cases.In term of knowledge of population sociology,disease conditions,scores of dietary knowledge of diabetes,blood biochemical parameters,and anthropometric indicators,there were no significant differences between the two groups(P＞0.05).Subjects of the test group received diet-education of the food exchange serving based on glycemic load, with a 3-month comprehensive nursing intervention and a 3-month follow-up,including 3 collective education sessions,3DM patients' salon activities,outpatient-consultations, telephone-consultations and related education materials.While those of the control group received diet-education of the traditional food exchange serving,with the same form, frequency and time of intervention as the test group.The scores of dietary knowledge of diabetes,daily nutrients,daily diet GL,blood biochemical parameters(fasting blood glucose(FBG),2h postprandial blood glucose(2hPBG),glycosylated hemoglobin(HbA1c), total cholesterol(TC),triglycerides(TG)) and anthropometric parameters(body mass index(BMI),waist circumference(WC),and blood pressure(BP)) were assessed after 3 months' intervention and 3 months' follow-up.The changes were compared by the mean, standard deviation,Chi-square test,independent-samples T test,repeated-measure ANOVA and multivariate ANOVA.Results①The structure of the dietary knowledge in the test group improved significantly:After the intervention,the results of a repeated-measures ANOVA showed that the scores of total dietary knowledge and GI/GL of the test group displayed an obvious upward trend compared with the control group(P＜0.001,P＜0.001).As is indicated by multivariate ANOVA,at the end of the intervention and 3 months later the changes of the scores of total dietary knowledge and GI/GL were significantly different between the test group and the control group(P＜0.001,P＜0.001).②The daily nutrients and daily diet GL in the test group improved significantly:After the intervention,the results of a repeated-measures ANOVA showed that carbohydrates,cholesterol and daily diet GL of the test group had an obvious downward trend compared with the control group(P＜0.01,P＜0.05, P＜0.05),while dietary fiber had an obvious upward trend compared with the control group (P＜0.05).By multivariate ANOVA,the result showed that participants in the test group consumed significantly less carbohydrates and cholesterol and more dietary fiber than the control group(P＜0.001,P＜0.05,P＜0.05),which led to lower daily diet GL(P＜0.05) at the end of the intervention and 3 months later.According to a repeated-measures ANOVA and multivariate ANOVA,there were no significant differences between the test group and the control group in total energy,protein and fat(P＞0.05).③The blood biochemical parameters in the test group decreased significantly:After the intervention,the results of a repeated-measures ANOVA showed that the FBG,2hPBG,HbA1c,TC of the test group demonstrated an obvious downward trend compared with those of the control group(P＜0.05, P＜0.01,P＜0.05,P＜0.05).As multivariate ANOVA indicated,at the end of the intervention and 3 months later,there were significant statistical differences between the test group and the control group in FBG,2hPBG,HbA1c and TC(P＜0.01,P＜0.001,P＜0.01,P＜0.001),but no significant difference in TG(P＞0.05).④The anthropometric parameters in the test group improved:After the intervention,the results of a repeated-measures ANOVA showed that BMI registered an obvious downward trend compared with the control group(P＜0.05). According to multivariate ANOVA,at the end of the intervention and 3 months later there was significant statistical difference in BMI between the test group and the control group(P＜0.01, P＜0.05).The results of the repeated-measures ANOVA and multivariate ANOVA indicate that there were no significant difference in WC or BP(P＞0.05).Conclusion The food exchange serving based on glycemic load is more effective than the traditional food exchange serving in diet education for Type 2 diabetes patients.