Authors (including presenting author) :
Ho ICH(1), Cheung KS(1), Chan KI(1), Yu VMW(1)
Affiliation :
(1)The Department of Dietetics, Queen Mary Hospital, Hong Kong
Introduction :
Adults with impaired fasting glucose (IFG) level, 5.6-6.9 mmol/L, are predisposed to higher risk of diabetes and other metabolic diseases. Convincing evidence from large-scale trials and meta-analysis had recognised the cost-effectiveness of dietitian-led diabetes prevention group education, achieving reduction of fasting glucose level (FGL) by 0.1-0.2 mmol/L and glycated haemoglobin (HbA1c) by 0.3%.
Objectives :
This prospective study investigated the effect of a community-based Dietitian-led Pre-diabetes Diet Education (Pre-DMDE) session on the relative risk of diabetes, and glycaemic control among adults with IFG.
Methodology :
184 mid-aged adults with IFG were enrolled in Pre-DMDE session held in 2 community family medicine clinics of Hong Kong West Cluster from 2017-2019. The dietitian-led session emphasised on dietary modification including: 1) dietary restriction on simple sugar, 2) carbohydrate control and making appropriate food choices, 3) sources of soluble and insoluble fibre, 4) healthy dining out, and 5) cooking tips; and active lifestyle, using patient-centered approach including self-reflection and goal setting. Control group, 180 adults with IFG, only received routine medical service during the period.
The relative risk of diabetes was derived from the incidences of diabetes in the control and pre-DMDE groups within 24 months after the session. Changes in FGL (mmol/L) and HbA1c (%) before and at least 6 month after the session were also compared with the control group.
Result & Outcome :
The incidence of diabetes was significantly reduced in Pre-DMDE group within 24 months after the session (Pre-DMDE: 10.4% Vs Control: 20.6%, P=0.007). The relative risk of 0.5 (95%CI: 0.3 to 0.8) indicated the Pre-DMDE group were 50% less likely to be diagnosed with diabetes than the control group.
Pre-DMDE participants yielded more prominent reduction of FGL (Pre-DMDE: -0.3 (0.7)mmol/L Vs Control: 0 (0.8)mmol/L, P=0.004) and HbA1c (Pre-DMDE: -0.1 (0.2)% Vs
Control: 0.1 (0.4)%, P=0.038) than the control group. Multivariate linear regression revealed significant association of Pre-DMDE session with reduction of FGL (β=-0.16, P=0.005) and HbA1c reduction (β=-0.31, P=0.003).
Pre-DMDE session illustrated the effective role of dietitian-led nutrition education in primary prevention of chronic disease via reduction of diabetes risk and improvement of glycaemic control among adults with IFG.
