| ObjectivesThrough implementation of intervention on healthy breakfast model of patients with type2diabetes mellitus for3months, we evaluated how community-based dietary structure adjustment and healthy diet management and intervention controlled and alleviated diabetes. And then we analyzed the patients’nutrition knowledge, attitude and behavior, also their dietary characteristic and nutritional status of the body. Thus, for the sake of patients with type2diabetes, a theoretical basis was provided for the design of health promotion program and the implementation of disease prevention measures.MethodsFrom July to September2011, among middle-aged and elderly population in Lixia, Licheng, Shizhong, Huaiyin and Tianqiao districts of Ji’nan city, we recruited207type2diabetic patients without severe complications,92males and115females included, on which we implemented for90days the intervention of nutritious breskfast pattern, consisting of making them have specific nutritious breakfast (powder mixture of nutrients, milk and fruit and vegetable juice), lunch and supper guidance, health education on diabetes knowledge and adjusting intervention scheme and intensity according to personal conditon. Questionnaire (contents includes the patients’knowledge, attitude and behavior about diabetes, also their condition and treatment) and dietary survey were carried out before and after the intervention respectively. The patients were examined FG, plasma glucose2hours after eating, glycated hemoglobin and serum lipid before, after45days of, and after the intervention respectively in the Second Hospital of Shandong University. And their body-related data were measured by investigators. After the intervention, we analyzed and evaluated the questionnaire survey, retrospective dietary survey and examination results.Results1. After the intervention, the population mean score of diabetes related knowledge increased (P<0.01), and both male and female mean scores of diabetes related knowledge rised compared with before intervention (P<0.05).2. The life quality awareness mean scores of the males and the population after intervention were higher than that before intervention (P<0.05). Compared with before intervention, among the population, the rate of correctly answering "life confidence" and "satisfication about medicine therapy" increased significantly (P<0.05). Bfore the intervention, the rate of positive answer about "confidence" of males were higher than that of females (P<0.05). And after the intervention, more percentage of men than women positively answered "stress from outside or family members"(P<0.05).3. The mean scores of attitude toward nutrition intervention between males and females didn’t differ significantly (P>0.05). Percentage of correct attitude toward new therapies for diabetes after intervention were higher than before intervention (P<0.05).4. Mean scores of behavior status of females were higher than that of males after intervention. Through intervention, male correct rates on food allocation of three meals, mealtimes, salt intaken and oil intake rised significantly (P<0.05) while their correct rate on tea drinking lowered obviously (P<0.05). More percentage of the females correctly have salt and fruits and choose drinks (P<0.05).5. After45days of intervention, the patients’blood sugar levels2hours after eating decreased significantly (P<0.05), and their levels of serum TC, HDL-C and LDL-C rises obviously (P<0.05). After90days of intervention, the patients’FBG, blood sugar2hour after eating, glycolated hemoglobin and TG significantly lowered, and their serum TC and HDLC-C both rised obviously (P<0.05), compared with before intervention. There was a significant reduction in their LDL-C level after90days of the intervention than after45days (P<0.05).6. After intervention, the population’s and both genders’weight and BMI lowered significantly (P<0.05). and population’s various body measurement indicators also lowered significantly (P<0.05), compared with before intervention.7. The intakes of energy, carbohydrate, cholesterol, sodium and selenium loered significantly (P<0.01) after the intervention. And the intakes of dietary fiber, thiamin, riboflavin, Vitamin B6, folic acid, Vitamin C, Vitamin E, calium, phosphorus, potassium, magnesium, iron, zinc, copper, iodine after intervention was significantly higher than before intervention (P<0.01), and it was the same with that of Vitamin A (P<0.05).8. After intervention, the intakes of cereals, potatoes, beans and eggs lowered significantly (P<0.05), and the intakes of vegetables, fruits, milks and dairy products per capita per day increased obviously (P<0.01).9. Breakfast supplied lower percentage of egergy in a whole day, the difference of which was of statistical significance (P<0.05). Both lunch and supper made up obviously larger proportions of daily egergy intake (P<0.01).10. After intervention, both protein and fat made up significantly larger proportions of egergy intake, the difference of which was of statistical significance (P<0.05); and carbohydrate obviously lower percentage of egergy (P<0.01).Conclusions1.Through intervention, the diabetes related knowledge, attitude and behavior of the population rised, for part of which there wasn’t much room for improvement. The effect of the intervention on the population was good.2.The effect of the breakfast intervention model on biochemical indicators was significant, and new features of changes of glucose and lipid mmetabolish of patients during a short period was discovered. The intervention on the physical measurement indicators of the patients was effective.3.After intervention, changes of various nutrients ware favorable for physical improvement of the diabetes patients, also preventive care of their other diseases. On the whole, the goal of intervention was reached.4.The intakes of vegetables, fruits, milks and dairy products per capita per day rised significantly after the intervention, which is quite effective. However, rational choice of fruits should be highlighted5.After intervention, supper egergy make up a larger proportion of a whole day, the intake of selenium decreased, and contribute rate of carbohydrate and fat in total egergy was lower than recommended, which lessons should be draw from and was to improve and perfect. |
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