The Study on the Effect of Nutritional Counseling in Diabetes Mellitus Patients with Microalbuminuria

미세단백뇨를 동반한 인슐린비의존형 당뇨병 환자를 대상으로 한 영양 상담의 효과 연구

Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.