Abstract
The aim of this study was to investigate the association between habitual dietary intake for patients with diabetes and the content of family support for medical nutritional therapy (MNT). Analyzed were 289 Japanese with type 2 diabetes (men, 58.5%; mean age, 62.0 years; mean HbA1c, 53.4 mmol/mol) who completed the Food Frequency Questionnaire and Diabetes Family Behavior Checklist (DFBC). Relationships of mean values for food group intake to DFBC responses regarding MNT were examined using multivariate analysis of covariance. Positive response to “Praise for following diet” was associated with lower sweets intake (none: 60.1 g/day; ≥once monthly: 50.9 g/day, p = 0.038) and higher seasoning intake (none: 21.6 g/day, ≥once monthly: 24.1 g/day, p = 0.046). Energy intake was higher with positive responses to “Eat at the same time that you do” (none: 1636 kcal/day, ≥once monthly: 1818 kcal/day, p = 0.038). “Nags about not following diet” was associated with higher fish (none: 68.7 g/day, ≥once monthly: 78.7 g/day, p = 0.042) and salt intake (none: 8.3 g/day, ≥once monthly: 9.0 g/day, p = 0.014). Eating foods not part of the diabetic diet (none: 218.4 g/day, ≥once monthly: 246.9 g/day, p = 0.014) resulted in a higher vegetable intake. In females, significant differences in relationships in the overall analysis were reversed. Our results clarified relationships between types of family support of patients with type 2 diabetes and their dietary intake and the importance of sex differences for more effective MNT.
Highlights
Self-care activities in the treatment of diabetes are crucial for improving glycemic control [1,2], reducing the risk of diabetes-related complications [2,3], and improving the prognosis [4]
There were no significant differences in age, diabetes duration, HbA1c level, body mass index (BMI), and usage of an oral hypoglycemic agents (OHA) and insulin between sexes
As to family support for diabetes care, among male patients, 87.6% were mainly supported by wives, while 65.8% of female patients were mainly supported by husbands and 16.6% obtained the strongest family support from their children (p < 0.001)
Summary
Self-care activities in the treatment of diabetes are crucial for improving glycemic control [1,2], reducing the risk of diabetes-related complications [2,3], and improving the prognosis [4]. Psychosocial care plays an important role in the practice of good self-care activities and has been associated with reducing stress, promoting positive emotions and behaviors [7,8], improving adherence to recommended treatment regimens, improving glycemic control [8], and preventing the aggravation of the disease [9]. HbA1c in diabetic patients was significantly lower when family members were involved than were not involved in family-oriented diabetes programs [11]. HbA1c levels were shown to be lower in patients with type 2 diabetes who had family support for MNT, who shared education sessions for MNT, engaged in patient-family member communication about MNT, and received assistance with food preparation and grocery shopping [13,14,15]
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