In order to examine the efficiency and the preferable period of handy nutrition guidance, we studied 91 outpatients with non-insulin dependent diabetes mellitus (NIDDM) who were given nutrition guidance for more than three months (25.4±18 months) in 1996. The subjects were composed of 68 males aged 53.2±9.9 and 23 females aged 61.6±12.5 (p<0.003), 14 of whom were on concomitant medicinal treatments. Biochemical data were observed through the time course on relationship of blood sugar, serum lipid, γ-GTP and obesity level (BMI) to the intake of nutrients, alcohol and sweets. The results were as follows.
1) After 12 months, HbA
1C, TC and TG decreased significantly to less than 7%, 200mg/d
l and 150mg/d
l respectively. HDL showed a tendency to increase and bodyweight to decrease, but these changes were not statistically significant after twelve months. TG increased after six months in males younger than 65 years of age and in patients with obesity level >110% at the time of study entry. On the other hand, γ-GTP increased again after six months in patients with γ-GTP>60mg/d
l at the time of study entry, but the change was not statistically significant after twelve months.
2) Intake of energy, protein and fat decreased, but
n-3 fatty acid increased after twelve months. Cholesterol intake level decreased significantly after twelve months in patients with TC>200mg/d
l before the nutrition guidance. These results indicate that nutrition/energy ratio was properly corrected and there was adequate intake of dietary fibers (22±45g) during this period. It was thus confirmed that this handy guidance could correct the nutrition intake to a proper level.
3) After twelve months, the total alcohol intake was reduced to less than 1, 750kcal/week and sweets to less than three times per week. The alcohol intake in patients with more than 1, 750kcal/wk at the time of study entry showed a tendency to decrease during the early period, but the intake exceeded 1, 750kcal/wk 12 months thereafter.
4) Sweets restricted to less than three times per week and between meals during daytime had no effect on HbA
1C, TC and TG in patients who took sufficient dietary fiders, vegetables and
n-3 fatty acid and decreased energy intake by evening meal. Alcohol intake had no effect on HdA
1C, but total alcohol intake was correlated to TC and γ-GTP in cases whose TG was greater than 150mg/d
l and γ-GTP was greater than 60μ/
l befor the nutrition guidance.
5) Nutrition guidance was continued for more than twelve months in 81% of all the patients and in 73.2% of those whose HbA
1C was less than 7%. It was also confirmed that HbA
1C decreased and serum lipid level improved even in patients who did not undergo the nutrition guidance for 12 months. These findings suggest that this handy nutrition guidance is useful and effective for treatment of NIDDM.
6) It is recommended to continue the nutrition guidance for more than twelve months for treatment of NIDDM in patients with high levels of γ-GTP and TG, the total alcohol intake of more than 1, 750kcal/wk and sweets intake of more than three times per week.
View full abstract