Michael E Bowen1, Kerri L Cavanaugh2, Kathleen Wolff3, Dianne Davis3, Rebecca P Gregory3, Ayumi Shintani4, Svetlana Eden4, Ken Wallston5, Tom Elasy6, Russell L Rothman7. 1. Division of General Internal Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; Division of Outcomes and Health Services Research, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA. 2. Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA. 3. Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA. 4. Department of Biostatistics, Vanderbilt University, School of Medicine, Nashville, TN, USA. 5. School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA. 6. Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA. 7. Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, School of Medicine, Nashville, TN, USA; Vanderbilt Diabetes Center, Vanderbilt University, School of Medicine, Nashville, TN, USA. Electronic address: russell.rothman@vanderbilt.edu.
Abstract
OBJECTIVE: To compare the effectiveness of different approaches to nutrition education in diabetes self-management education and support (DSME/S). METHODS: We randomized 150 adults with type 2 diabetes to eithercertified diabetes educator (CDE)-delivered DSME/S with carbohydrate gram counting or the modified plate method versus general health education. The primary outcome was change in HbA1C over 6 months. RESULTS: At 6 months, HbA1C improved within the plate method [-0.83% (-1.29, -0.33), P<0.001] and carbohydrate counting [-0.63% (-1.03, -0.18), P=0.04] groups but not the control group [P=0.34]. Change in HbA1C from baseline between the control and intervention groups was not significant at 6 months (carbohydrate counting, P=0.36; modified plate method, P=0.08). In a pre-specified subgroup analysis of patients with a baseline HbA1C 7-10%, change in HbA1C from baseline improved in the carbohydrate counting [-0.86% (-1.47, -0.26), P=0.006] and plate method groups [-0.76% (-1.33, -0.19), P=0.01] compared to controls. CONCLUSION: CDE-delivered DSME/S focused on carbohydrate counting or the modified plate method improved glycemic control in patients with an initial HbA1C between 7 and 10%. PRACTICE IMPLICATIONS: Both carbohydrate counting and the modified plate method improve glycemic control as part of DSME/S.
RCT Entities:
OBJECTIVE: To compare the effectiveness of different approaches to nutrition education in diabetes self-management education and support (DSME/S). METHODS: We randomized 150 adults with type 2 diabetes to either certified diabetes educator (CDE)-delivered DSME/S with carbohydrate gram counting or the modified plate method versus general health education. The primary outcome was change in HbA1C over 6 months. RESULTS: At 6 months, HbA1C improved within the plate method [-0.83% (-1.29, -0.33), P<0.001] and carbohydrate counting [-0.63% (-1.03, -0.18), P=0.04] groups but not the control group [P=0.34]. Change in HbA1C from baseline between the control and intervention groups was not significant at 6 months (carbohydrate counting, P=0.36; modified plate method, P=0.08). In a pre-specified subgroup analysis of patients with a baseline HbA1C 7-10%, change in HbA1C from baseline improved in the carbohydrate counting [-0.86% (-1.47, -0.26), P=0.006] and plate method groups [-0.76% (-1.33, -0.19), P=0.01] compared to controls. CONCLUSION: CDE-delivered DSME/S focused on carbohydrate counting or the modified plate method improved glycemic control in patients with an initial HbA1C between 7 and 10%. PRACTICE IMPLICATIONS: Both carbohydrate counting and the modified plate method improve glycemic control as part of DSME/S.
Authors: Mary Margaret Huizinga; Adam J Carlisle; Kerri L Cavanaugh; Dianne L Davis; Rebecca P Gregory; David G Schlundt; Russell L Rothman Journal: Am J Prev Med Date: 2009-04 Impact factor: 5.043
Authors: John P Bantle; Judith Wylie-Rosett; Ann L Albright; Caroline M Apovian; Nathaniel G Clark; Marion J Franz; Byron J Hoogwerf; Alice H Lichtenstein; Elizabeth Mayer-Davis; Arshag D Mooradian; Madelyn L Wheeler Journal: Diabetes Care Date: 2008-01 Impact factor: 19.112
Authors: Kerri Cavanaugh; Mary Margaret Huizinga; Kenneth A Wallston; Tebeb Gebretsadik; Ayumi Shintani; Dianne Davis; Rebecca Pratt Gregory; Lynn Fuchs; Robb Malone; Andrea Cherrington; Michael Pignone; Darren A DeWalt; Tom A Elasy; Russell L Rothman Journal: Ann Intern Med Date: 2008-05-20 Impact factor: 25.391
Authors: Silvio E Inzucchi; Richard M Bergenstal; John B Buse; Michaela Diamant; Ele Ferrannini; Michael Nauck; Anne L Peters; Apostolos Tsapas; Richard Wender; David R Matthews Journal: Diabetes Care Date: 2012-04-19 Impact factor: 19.112
Authors: Rob McCarney; James Warner; Steve Iliffe; Robbert van Haselen; Mark Griffin; Peter Fisher Journal: BMC Med Res Methodol Date: 2007-07-03 Impact factor: 4.615
Authors: Derek LeRoith; Geert Jan Biessels; Susan S Braithwaite; Felipe F Casanueva; Boris Draznin; Jeffrey B Halter; Irl B Hirsch; Marie E McDonnell; Mark E Molitch; M Hassan Murad; Alan J Sinclair Journal: J Clin Endocrinol Metab Date: 2019-05-01 Impact factor: 5.958
Authors: Richard O White; Rosette James Chakkalakal; Kenneth A Wallston; Kathleen Wolff; Becky Gregory; Dianne Davis; David Schlundt; Karen M Trochez; Shari Barto; Laura A Harris; Aihua Bian; Jonathan S Schildcrout; Sunil Kripalani; Russell L Rothman Journal: J Gen Intern Med Date: 2020-01-09 Impact factor: 5.128
Authors: Rosette J Chakkalakal; Sneha Venkatraman; Richard O White; Sunil Kripalani; Russell Rothman; Kenneth Wallston Journal: Health Lit Res Pract Date: 2017-04-21
Authors: Robin Whittemore; Mireya Vilar-Compte; Selene De La Cerda; Roberta Delvy; Sangchoon Jeon; Soraya Burrola-Méndez; Mariana Pardo-Carrillo; Annel Lozano-Marrufo; Rafael Pérez-Escamilla Journal: Curr Dev Nutr Date: 2020-04-14