Table_1_Patient-centered nutrition education improved the eating behavior of persons with uncontrolled type 2 diabetes mellitus in North Ethiopia: a quasi-experimental study.docx

BackgroundImproving the clinical outcome of people with type 2 diabetes mellitus by modifying their eating behavior through nutrition education is an important element of diabetes self-management. Significant data from the literature supports this idea, however in the Ethiopian setting, there is a practice gap. Therefore, the purpose of this study was to assess how patient-centered nutrition education affected the eating behavior and clinical outcomes of people with uncontrolled type 2 diabetes mellitus.
MethodIn this quasi-experimental trial, 178 people with uncontrolled type 2 diabetes were purposely assigned to the intervention (n = 89) or control (n = 89) arm. The intervention arm was given patient-centered nutrition education, whereas the control arm received the routine care. Eating behavior and clinical outcome indicators such as HbAc, lipid profile, anthropometric indices, and blood pressure were assessed in both groups at the start and completion of the intervention. All scale variables were tested for normality and log transformed when appropriate. The baseline characteristics of the intervention and control groups were compared using the t-test for continuous variables and the chi-square test for categorical variables. The effect of nutrition education was determined using a difference in differences (DID) approach. P < 0.05 was established as the criterion of significance.
ResultFood selection (DID = 15.84, P < 0.001), meal planning (DID = 31.11, P < 0.001), and calorie needs (DID = 37.65, P < 0.001) scores were statistically higher in the nutrition education arm. Furthermore, their overall eating behavior score (DID = 27.06, P < 0.001) was statistically greater than the controls. In terms of clinical outcomes, the overall picture reveals that the intervention did not outperform over the routine care. However, in comparison to the controls, the intervention arm showed clinically significant improvement in HbA1c (DID = −0.258, P = 0.485).
ConclusionPatient-centered nutrition education has resulted in positive adjustments in the eating behavior of people with uncontrolled type 2 diabetes mellitus. Furthermore, it has shown a great potential for improving their glycemic control.

背景：通过营养教育改变饮食行为以改善2型糖尿病（type 2 diabetes mellitus）患者的临床结局，是糖尿病自我管理的核心环节之一。现有文献已积累大量数据支持这一理念，但在埃塞俄比亚的临床实践中，该方案仍存在落实缺口。为此，本研究旨在评估以患者为中心的营养教育（patient-centered nutrition education）对未控制2型糖尿病患者饮食行为及临床结局的影响。
方法：本研究为类实验性试验，采用目的性分配方式将178名未控制2型糖尿病患者分为干预组（n=89）与对照组（n=89）。干预组接受以患者为中心的营养教育，对照组则仅接受常规临床护理。于干预开始及干预结束两个时间点，对两组患者的饮食行为与临床结局指标进行测评，测评指标包括糖化血红蛋白（HbAc）、血脂谱、人体测量学指标及血压。对所有计量资料进行正态性检验，必要时实施对数转换以满足分析要求。采用t检验比较两组连续型基线特征，卡方检验比较两组分类基线特征。通过双重差分（difference in differences, DID）法分析营养教育的干预效应，以P<0.05作为统计学显著性判定标准。
结果：干预组在饮食选择（DID=15.84，P<0.001）、膳食规划（DID=31.11，P<0.001）及热量需求认知（DID=37.65，P<0.001）三个维度的得分均显著高于对照组。此外，干预组的整体饮食行为得分（DID=27.06，P<0.001）同样显著优于对照组。就临床结局而言，整体分析显示干预组并未优于常规护理组；但与对照组相比，干预组在糖化血红蛋白（HbA1c）指标上展现出具有临床意义的改善（DID=-0.258，P=0.485）。
结论：以患者为中心的营养教育可有效促使未控制2型糖尿病患者的饮食行为产生积极转变。同时，该干预手段在改善患者血糖控制方面具备可观的应用潜力。