Diabetes Mellitus Treated with Medical Nutritional Therapy and Self Blood Glucose Monitoring: A Randomized Controlled Trial.

OBJECTIVE

To assess the effect of Medical Nutritional Therapy (MNT) combined with self blood glucose monitoring (SBGM) in the clinical outcomes of patients with type 2 diabetes.

MATERIAL AND METHOD: A randomized controlled trial was conducted on patients with uncontrolled, not-using insulin type 2 diabetes at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center Sixty patients were recruited and randomized equally into intervention group (MNT with SBGM) and control group (usual care). The primary endpoint was improvement of hemoglobin A₁c (HbA₁c) at 12 and 24 weeks.

RESULTS

At 12 and 24 weeks the intervention group had significantly improved their glycemic control in comparison to control group (median decrement of HbA₁c at 12 weeks 0.72% vs. 0.15%; p < 0.001 and at 24 weeks 0.85% vs. 0.20%; p < 0.001). Oral hypoglycemic agents were reduced or discontinued in 7 patients in the intervention group and 1 patient in control group who achieved HbA₁c goal after 24 weeks (p = 0.037). After 24 weeks, body weight was significantly decreased from baseline (2.3 kg, p < 0.001) in the intervention group while only non-significant decrease was observed in control group (0.1 kg, p = 0.632).

CONCLUSION

MNT combined with SBGM is an effective non-pharmacological intervention for patients with uncontrolled type 2 diabetes.