Nutrition Evaluation and Assessment of Patient Care. Quarterly Outcome Analysis for Diabetes Mellitus

Abstract

LEARNING OUTCOME: To evaluate and assess the effectiveness of medical nutrition therapy on glycohemoglobin levels and weight changes in patients referred for diabetes after at least two nutrition counseling sessions over a six-month period. Patients with diabetes comprise a large number of people seen at the outpatient nutrition center of a major teaching hospital. This study examines glycohemoglobin and weight changes in patients with diabetes who had at least two nutrition visists within a six-month period. Analyses were performed in June, September, December and March of each year for patients who attended initial appointments during one month, six months prior. Data collected was initial and final weights, lab values, cost of services, the number of visits, total time spent with the nutritionist, and relevant medications patients were taking. The number of patients experiencing a positive change was recorded, the percent of change, and the cost for this amount of change. Seven quarters have been completed. Forty-two patients returned for a followup visit. Lab data on glycohemoglobin was incomplete for eleven patients. Twenty-seven patients or 87 percent decreased glycohemoglobin levels. Sixty percent or 25 of the 42 lost weight. Of the 27 patients taking hypoglycemic medication, eight or 30 percent decreased medication dose. The average cost for decreasing glycohemoglobin levels was $161. Medical nutrition therapy is effective in decreasing glycohemoglobin levels and weight in patients with diabetes mellitus and is cost effective. Further studies could compare the effectiveness of one nutrition visit versus further followup on the above indices.