Abstract
Behavioral medicine interventions for pre-dialysis patients with diabetic nephropathy are important, but diabetes clinics often find it difficult to conduct such interventions as compared with general hospitals. We provided multidisciplinary care over a 10-month period to patients with diabetic nephropathy. This care consisted of a nutrition education program and a clinical psychological intervention. We recruited 10 consecutive adult patients with diabetic nephropathy (mean age = 67.4 years). The patients received individual counseling sessions over 10 months from a clinical psychologist and underwent individual and group dietary interventions conducted by a registered dietitian. Both interventions were provided monthly during patients’ regular medical examinations. A clinical psychologist specializing in cognitive-behavioral therapy also conducted an assessment and consultation with clinic medical staff. In addition, joint conferences were held involving co-medical staff and a doctor. Five months after the start, the estimated glomerular filtration rate was found to have increased significantly. Uric acid and total cholesterol levels decreased significantly at 10 months. Although diabetes clinics often have limited time and other resources for diabetic nephropathy care, our results indicate that a behavioral medicine approach is effective in treating diabetic nephropathy.
