Feeding behavior pattern and glycosylated hemoglobin in people with type 2 diabetes at the beginning and end of an educational intervention

Abstract

ObjectiveTo assess the changes in food consumption pattern and glycosylated hemoglobin levels in patients with type 2 diabetes after an educational intervention. Materials and methodsA descriptive study in people over 18 years of age with type 2 diabetes receiving the educational intervention provided by the health facilities of the Costa Rican Social Security. Sociodemographic, biochemical, and anthropometric variables were collected. Glycemic control was classified as good (≤7%), fair (7.1–8%), and poor (>8%). The usual daily diet record was used to assess the food consumption pattern based on the 11 criteria, divided into the following categories: poor compliance (0–3 criteria), fair compliance (4–7 criteria), and good compliance (8–11 criteria). Data collected were processed using SPSS version 16 software. A Student's t test was used for dependent samples. The impact of the educational intervention on metabolic control and food consumption pattern was determined using a McNemar test with a level of significance of 5% for hypothesis testing. ResultsThe study sample consisted of 702 patients with a mean age of 54.5±11.6 years, 73.8% females. Mean initial glycosylated hemoglobin level was 8.8±2.14%, while final level was 7.8±1.78% (p<0.05). Glycosylated hemoglobin levels less than 7% were found in 23.9% of the population at study start and in 41.3% at study end. As regard the food consumption pattern, the mean number of criteria met was 6±3 at study start and 9±2 at study end (p<0.000). Mean glycosylated hemoglobin level showed at the start of intervention a similar behavior in all 3 categories of the food consumption pattern, and at the end the changes in glycosylated hemoglobin in the poor and fair compliance categories were statistically significant (p<0.022 and p<0.000 respectively), unlike in the good compliance category (p<0.065). At the end of the intervention, of the 75.6% of the population with good compliance, 41.3% had good metabolic control (p<0.0001). The educational intervention was significant (p<0.000) using the McNemar test. ConclusionThe educational intervention approach to nutritional therapy had a positive impact on the food consumption pattern and glycosylated hemoglobin levels, showing that therapeutic education is part of the treatment of diabetes to achieve the objectives.