The Effect of a Comprehensive Lifestyle Modification Program on Glycemic Control and Body Composition in Patients with Type 2 Diabetes

This study was carried out to assess the effectiveness of lifestyle modification counseling using lifestyle intervention holistic model and its adherence towards glycemic control in type 2 diabetes mellitus patients. This quasi-experimental prospective study was conducted among 224 type 2 diabetes mellitus patients in Delhi Diabetes Research Center, New Delhi. The study participants were allocated to lifestyle modification counseling group (intervention) and usual care (control) group based on receiving or not receiving lifestyle modification counseling using lifestyle intervention holistic model. Effect of counseling on glycemic control was assessed at baseline and follow up of both the groups at 3rd, 6th and 12th months after receiving lifestyle modification counseling. The collected data was analyzed for percentage, mean, median, standard deviation, chi-squared, t-test and Wilcoxon test. In this study, the lifestyle modification counseling proved to be effective and showed significant improvement in fasting blood sugar (175.5±32.3 to 144.7±17.6), postprandial blood sugar (275.5±61. to199.0±48.3), hemoglobin A1c by 9.3±1.5 to 8.4±1.3. Significant improvement was observed in diastolic blood pressure (82.6±7.0 to79.4±6.1) and high-density lipoproteins cholesterol (47.3±10.5 to 58.8±5.6) from 3rd to 12th months follow up with significant p value 0.001 in the intervention group. The study showed good adherence to balanced diet, physical activity, and tobacco and alcohol cessation but less adherence was observed towards meditation for stress management, regular checkups, and medicine adherence. Lifestyle modification counseling is an effective, noninvasive approach towards glycemic control in type 2 diabetes mellitus patients. Lifestyle intervention holistic model used in this counseling may be helpful for type 2 diabetes mellitus patients to improve adherence and self-care behavior towards the management of their diabetes.

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The psychological component of comprehensive lifestyle modification program in overweight (obese) patients with type 2 diabetes mellitus

Problems of Endocrinology ◽

10.14341/probl9420 ◽

2018 ◽

Vol 64 (2) ◽

pp. 93-104

Author(s):

Svetlana I. Andreeva ◽

Larisa M. Rudina ◽

Larisa V. Savelyeva ◽

Maria V. Gurkina ◽

Elena V. Surkova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Lifestyle Modification ◽

Metabolic Parameters ◽

Psychological Characteristics ◽

Obese Patients ◽

Lifestyle Modification Program ◽

Clinically Significant

Background. Despite the emergence of new modern classes of antihyperglycemic medications, lifestyle modification of patient with type 2 diabetes mellitus (T2DM) is a necessary component of the therapeutic approach in this disease. Clinically significant weight reduction and its maintenance is extremely important, but elusive goal for most patients with T2DM in the real clinical practice. The use of specially developed programs with involvement of the different profiles specialists (endocrinologists, dieticians, psychologists, instructors or сlinical exercise physiologists) can greatly contribute to this task. Aims — to study individual psychological characteristics in overweight (obese) patients with T2DM and to evaluate the dynamic of these characteristics, anthropometric, clinical and metabolic parameters during the comprehensive lifestyle modification program. Material and methods. The lifestyle modification program was developed. The main structural components of this program were dietary intervention, dosed individualized exercise intervention, specific model of team psychotherapeutic work (health coaching), comprehensive group education and dynamic medical support of patients with the adaptation of drug therapy. Psychological characteristics of patients, clinical and metabolic parameters and the level of physical activity were assessed before inclusion, at 3 and 12 months of follow-up. Results. The study was completed by 55 people of 60 (5 people dropped out of the study because of various reasons). There were not undesirable phenomena, directly related to participation in the program. At the end of the study we noted the positive dynamics of psychological characteristics in patients: 15% of men and 22% of women became less inclined to self-blame and hyper-responsibility; the locus of control in a relationship to own capabilities of health management changed from external to internal in 30% of women and 41% of men. 65% of participants achieved clinically significant weight loss (most patients reduced MT by 10% or more) and retained this result during 1 year. Improvement of clinical and metabolic parameters was also noted. Conclusions. The multidisciplinary lifestyle modification program in overweight (obese) patients with T2DM, the most important part of which was team psychotherapeutic work, showed high effectiveness of both the reduction of MT and the improvement of clinical and metabolic parameters in the long-term period.

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Association between Glycemic Indices, hs-CRP and Anthropometrical Parameters of Patients with Type 2 Diabetes Mellitus

The Indian Journal of Nutrition and Dietetics ◽

10.21048/ijnd.2018.55.2.18153 ◽

2018 ◽

Vol 55 (2) ◽

pp. 187

Author(s):

Hetal N. Parekh ◽

Subhadra Mandalika ◽

Suresh Mehtalia

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Body Composition ◽

Glycemic Control ◽

Blood Sugar ◽

Poor Glycemic Control ◽

Dietary Practices ◽

Hs Crp

Risk of obesity, inflammatory conditions and poor glycemic control have been reported to be lower among vegetarian T2DM patients due to their lower intake of fat, high intake of dietary fiber and micronutrients. However, several factors influence dietary practices and thereby glycemic control among patients which demands in depth observation. A cross-sectional observational study to examine the association between body composition, glycemic control and hs-CRP of Type 2 Diabetes Mellitus (T2DM) patients was conducted on 160 uncontrolled T2DM patients including 81 (50.6%) vegetarians and 79 (49.4%) non-vegetarians with mean age of 49.8±7.2 years. They were assessed for body composition using anthropometry. Biochemical parameters [(Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), Glycosylated Hemoglobin (HbA1c) and high sensitive C Reactive Protein (hs-CRP)] were obtained from their case files. Data were analysed using SPSS software for Windows (Version 16.0, 2007, SPSS Inc, Chicago IL). Anthropometric indices (weight, BMI, WC, hip circumference, WHR, BMR, visceral fat) and hs-CRP levels were significantly higher in vegetarians than non-vegetarians (p<0.05). However, there was no significant difference in FBS, PPBS and HbA1C between the two groups (p>0.05). Vegetarian participants had higher hs-CRP (≤3.0 mg/dl) and poor glycemic control. A positive correlation of anthropometry indices with hs-CRP was also observed among the participants (p<0.05). Dietary practices of vegetarians might vary across the populations and communities and hence there is a strong need to strictly consider these differences in the development of dietary strategies for T2DM.

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