Thursday, July 29, 2010

Intervensi gizi untuk pasien diabetes tipe 2

Penelitian ini membuktikan bahwa diet dapat memperbaiki parameter glikemik dan antropometrik untuk penderita diabetes tipe 2 yang belum terkontrol dengan pengobatan.

BMJ 2010;341:c3337
Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment—Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial
Kirsten J Coppell, senior research fellow1, Minako Kataoka, research dietitian2, Sheila M Williams, research associate professor3, Alex W Chisholm, senior lecturer nutrition2, Sue M Vorgers, research nurse2, Jim I Mann, professor of human nutrition and medicine1
1 Edgar National Centre for Diabetes and Obesity Research, Department of Medical and Surgical Sciences, University of Otago, PO Box 913, Dunedin 9054, New Zealand, 2 Department of Human Nutrition, University of Otago, 3Department of Preventive and Social Medicine, University of Otago

Objective To determine the extent to which intensive dietary intervention can influence glycaemic control and risk factors for cardiovascular disease in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment.
Design Randomised controlled trial.
Setting Dunedin, New Zealand.
Participants 93 participants aged less than 70 years with type 2 diabetes and a glycated haemoglobin (HbA1c) of more than 7% despite optimised drug treatments plus at least two of overweight or obesity, hypertension, and dyslipidaemia.
Intervention Intensive individualised dietary advice (according to the nutritional recommendations of the European Association for the Study of Diabetes) for six months; both the intervention and control participants continued with their usual medical surveillance.
Main outcome measures HbA1c was the primary outcome. Secondaryoutcomes included measures of adiposity, blood pressure, and lipid profile.
Results After adjustment for age, sex, and baseline measurements, the difference in HbA1c between the intervention and control groups at six months (–0.4%, 95% confidence interval –0.7% to –0.1%) was highly statistically significant (P=0.007), as were the decreases in weight (–1.3 kg, –2.4 to –0.1 kg; P=0.032), body mass index (–0.5, –0.9 to –0.1; P=0.026), and waist circumference (–1.6 cm, –2.7 to –0.5 cm; P=0.005). A decrease in saturated fat (–1.9% total energy, –3.3% to –0.6%; P=0.006) and an increase in protein (1.6% total energy, 0.04% to 3.1%; P=0.045) in the intervention group were the most striking differences in nutritional intake between the two groups.
Conclusions Intensive dietary advice has the potential to appreciably improve glycaemic control and anthropometric measures in patients with type 2 diabetes and unsatisfactory HbA1c despite optimised hypoglycaemic drug treatment.

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