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http://dx.doi.org/10.4163/kjn.2010.43.1.46

Effects of Low Glycemic Index Nutrition Education on the Blood Glucose Control in Patients with Type 2 Diabetes Mellitus  

Kim, Mi-Ja (Department of Food and Nutrition, Chungnam National University)
Kwon, Sun-Ja (Department of Nutrition and Foodservice Management, Paichai University)
Ly, Sun-Yung (Department of Food and Nutrition, Chungnam National University)
Publication Information
Journal of Nutrition and Health / v.43, no.1, 2010 , pp. 46-56 More about this Journal
Abstract
This study was intended to assess the effects of low glycemic index (LGI) nutrition education on dietary management and glycemic control of patients with type 2 diabetes mellitus. The subjects were 48 sex-matched patients with type 2 diabetes mellitus, aged $66.5\;{\pm}\;6.2$ years, visiting a public health center. They were divided into two groups: the control group (males 10, females 14) and the educated group (males 10, females 14). The educated group was provided with a LGI nutrition education program for 7 weeks. The control group was educated only one time for general diabetic education. Anthropometric indices, knowledge and perception of efficacy of low glycemic index carbohydrates, dietary glycemic index (DGI) and glycemic load (DGL), fasting blood glucose, and HbA1c were assessed. In the educated group body weight, body mass index and systolic blood pressure (from $138.0\;{\pm}\;18.9\;mmHg$ to $130.6\;{\pm}\;15.0\;mmHg$) were significantly reduced after the nutrition education (p < 0.05). The scores of knowledge and perception of efficacy of low glycemic index carbohydrates increased significantly in the educated group. Dietary glycemic index and glycemic load of the educated group decreased significantly from $103.4\;{\pm}\;67.6$ to $45.4\;{\pm}\;27.1$ (p < 0.001), and from $173.3\;{\pm}\;135.9$ to $66.8\;{\pm}\;50.4$ (p < 0.001), respectively. Also fasting blood glucose and HbA1c levels of the educated group significantly decreased from $124.5\;{\pm}\;28.8\;mg/dL$ to $96.7\;{\pm}\;21.6\;mg/dL$ (p < 0.001) and from $7.1\;{\pm}\;1.3%$ to $6.4\;{\pm}\;1.2%$ (p < 0.05), respectively. The score of knowledge and perception of efficacy of low glycemic index significantly correlated with fasting blood glucose and HbA1c levels negatively. DGI, DGL and duration of diabetes significantly correlated with HbA1c level positively. From stepwise multiple linear regression analysis, DGI, DGL and the duration of diabetes were extracted as factors influencing HbA1c level of the subjects. The results of this study suggest that low glycemic index nutrition education programs is an effective intervention measure for the glycemic control in type 2 diabetic patients.
Keywords
diabetes mellitus; low glycemic index nutrition education; dietary glycemic index; dietary glycemic load; HbA1c;
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Times Cited By KSCI : 10  (Citation Analysis)
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1 Lee HJ, Yoon JS. Analysis of dietary behavior of type 2 diabetic patients visiting public health center. J Korean Dietetic Assoc 2005; 11(2): 223-232
2 Kim JH. Effect of education on knowledge, attitude and behavior about dietary therapy and blood glucose control in type 2 diabetic patients[master thesis]. Daegu: Keimyung University; 2002
3 Jenkins DJ, Wolever TM, Taylor RH, Barkder H, Fielden H, Baldwin JM. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 1981; 34(3): 362-366
4 Roberts SB. High glycemic index foods, hunger and obesity: Is there a connection? Nutr Rev 2000; 48: 163-169
5 Tan KCB, Chow WS, Tam SCF. Atrovastatin lower C-reactive protein and improves endothelium-dependent vasodilation in type 2 DM. J Clin Endocrinology and Metabolism 2002; 87(2): 563-568   DOI   ScienceOn
6 Lee HJ, Yoon JS. Analysis of dietary behavior of type 2 diabetic visiting Public Health Center. J Korean Dietetic Assoc 2005; 11(2): 223-232
7 www.gitest.co.kr
8 Shin YS, Kim OY, Lee HK. Risk factors for non-insulin dependent diabetes mellitus. J Korean Diabetes Assoc 2006; 20: 14-24
9 www.kosso.or.kr
10 Davis JN, Alexander KE, Ventura EE, Kelly LA, Lane CJ, Byrd- Williams CE, Toledo-Corral CM, Robers CK, Spruijt-Metz D, Weigensberg MJ, Goran MI. Associations of dietary sugar and glycemic index with adiposity and insulin dynamice in overweight Lation youth. Am J Clin Nutr 2007; 86: 1331-1339
11 Lee SL, Kim YL, Lee SJ, Cho YK, Choi YK, Chun CH, Chang YK. Effects of diabetes education on diabetic management in non-insulin-dependent diabetes mellitus patients. J Korean Dietetic Assoc 2004; 10(3): 300-308
12 American Diabetes Association. The prevention of delay of type 2 diabetes. Diabetes Care 2003; 26: 62-69   DOI
13 Du H, Van der ADL, Feskens EJ. Dietary glycaemic index: a review of the physiological mechanical mechanism and observed health impacts. Acta Cardiol 2006; 61: 383-397   DOI   ScienceOn
14 Kim EK, Lee JS, Hong HO, Yu DH. Association between glycemic index glycemic load, dietary carbohydrates and diabetes from Korean National Health and Nutrition Survey 2005. Korean J Nutr 2009; 42(7): 622-630   DOI   ScienceOn
15 Lee JS, Lee JS, Yang CB, Shin HK. Blood glucose response to some cereals and determination of their glycemic index to rice as the standard food. Korean J Nutr 1997; 30: 1170-1179
16 Kim TY, UM SH. Older adults with type 2 diabetes improve glycemic control after nutrition education program at the public health center. J Korean Dietetic Assoc 2004; 10(2): 205-217
17 Kelley DE. Managing obesity as first-line therapy for diabetes mellitus. Nutr Clin Care 1998; 1: 38-43
18 Lee C, Shin JS. Effects of different fiber content of rice on blood glucose and triglyceride levels in normal subject. J Korean Soc Food Sci Nutr 2002; 31(6): 1048-1051   DOI
19 Yim KS, Min YH, Lee TY. Evaluations of the elderly nutrition improvement program in the Community Health Center: effects of nutrition counseling and education program on elderly dietary behavior. J Korean Dietetic Assoc 1997; 3(2): 197-210
20 American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2008; 31(Suppl 1): 12-54
21 Kim ES, Lee SJ, Ryu OH, Lee JY, Yun HS, Choi MJ. The relationship of family support with blood glucose control in elderly type 2 diabetic patients. J Korean Clinical Diabetes 2007; 31(5): 435-443
22 Park GS, Ly SY. Compliance and need assessment for diet Therapy among diabetics and their caregivers. Korean J Community Nutr 2003; 8(1): 91-101
23 Yoon SK, Kim MA. Glycemic responses of Korean domestic meals and diabetic meals in normal subjects. J Korean Soc Food Sci Nutr 1998; 11(3): 303-311
24 Wolever TM, Nguyen PM, Chiasson JL, Hunt JA, Josse RG, Palmason C, Rodger NW, Ross SA, Ryan EA, Tan MH. Determinants of diet glycemic index calculated retrospectively from diet records of 342 individuals with non-insulin-dependent diabetes mellitus. Am J Clin Nutr 1994; 59(6): 1265-1269
25 Rosner BA, Speizer FE, Manson JE. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women: the Nurses' Health Study. Am J Epidemiol 1997; 145: 614-619
26 Yunsheng Ma, Olendzki B, Chiriboga D, Hebert JR, Youfu Li, Wenjun Li, Campbell MJ, Gendreau K, Ockene IS. Association between dietary carbohydrates and body weight. Am J Epidemiol 2005; 161: 359-367   DOI   ScienceOn
27 Sahyuun NR, Anderson AL, Kanaya AM, Koh-Banerjee P, Kritchevsky SB, de Rekeneire N, Tylavsky FA, Schwartz AV, Lee JS, Harris TB. Dietary glycemic index and load, measures of glucose metabolism and body fat distribution in older adults. Am J Clin Nutr 2005; 82(3): 545-552
28 Ministry for health, welfare and family affairs. The third Korea national health and nutrition examination survey (2005)-nutrition survey-; 2006
29 Matti U. The maintenance of improved metabolic control after intensified diet therapy in recent type 2 Diabetes. Diabetes Res Clin Pract 1993; 19(3): 227-238   DOI   ScienceOn
30 Murakami K, Sasaki S, Okubo H, Takahashi Y, Hosoi Y, Itabashi M. Dietary fiber index: a cross-sectional study of 3931 Japanese women aged 18-20 years. Eur J Clin Nutr 2007; 61(8): 986-995   DOI   ScienceOn
31 Son SM, Kim MJ. The effect of nutrition education program for various chronic disease in elderly visiting public health center. Korean J Nutr 2001; 6(4): 668-677
32 Lee SL. GI (Glycemic Index). J Korean Diabetes Assoc 2006; 7(2): 155-159
33 Wolever TM, Jenkins DJ, Jenkins AL, Josse RG. The glycemic index: methodology and clinical implications. Am J Clin Nutr 1991; 54(5): 846-854
34 Moon SJ, Sohn CY, Kim HS, Lim HS, Lee HC, Huh KB. Measurement of nutrition counseling effects for diabetes mellitus patients. Korean J Nutr 1994; 27(10): 1070-1077
35 Jenkins DJA, Leeds AR, Gassull MA, Wolever TMS, Goff DV, Alberti KGMM, Hockaday TDR. Unabsorbable carbohydrates and diabetes: Decreased post-prandial hyperglycemia. Lancet 1976; 2(7978): 172-174
36 Spieth LE, Harnish JD, Lenders CM, Raezer LB, Pereia MA, Hangen SJ, Ludwig DS. A low-glycemic index diet in the treatment of pediatric obesity. Arch Pediatr Adolesc Med 2000; 154(9): 947-951
37 Korea Diabetes Association, Guidelines of diabetes education; 2006
38 Johanna B, Palma J, Longe. Low-glycemic index carbohydrates: an effective behavioral change for glycemic control and weight management in patients with type 1 and 2 diabetes. The Diabetes Educator 2006; 32: 78-88   DOI   ScienceOn
39 Foster-Powell K, Holt SHA, Brand-Miler JC. International table of glycemic index and glycemic load values. Am J Clin Nutr 2002; 76: 5-56
40 Ludwig DS. Dietary glycemic index and obesity. J Nutr 2000; 130(2): 280-300
41 Korea Centers for Disease Control and Prevention. In-Depth Analysis on the 3rd (2005) Korea Health and Nutrition Examination Survey-Nutrition Survey-; 2007
42 Willett W, Manson J, Lui S. Glyemic index, glycemic load, and risk of type 2 Diabetes. Am J Clin Nutr 2002; 76(1): 274-280
43 Chai HJ, Hong HO, Kim HS, Lee JS, Yu CH. Relationship between food intakes, glycemic index, glycemic load, and body weight among high school boys in Seoul. Korean J Nutr 2008; 41(7): 645-657