Evaluation of effect of dietary education for prevention of Type 2 diabetes

目的：为了评估在一项随机对照试验的饮食教育，以防止2型糖尿病的日本男性workers.RESEARCH设计和方法的高风险患者的有效性：这项研究是一项前瞻性的，随机的，对照临床试验的两个层次的饮食教育（DE）的人与新的DE程序或传统的DE。新DE的目标是达到和维持最佳血糖水平，适当地改变营养摄入和生活方式以预防，满足个人营养需求，考虑个人和文化偏好，同时尊重个人意愿和改变意愿，并促进健康的食物摄入模式。本研究假设在1年内，新的DE可使1个月和6个月DE的2小时空腹血糖（2小时FPG）降低10%。研究对象为141名年龄在35岁以上的男性工人，他们被诊断为2型糖尿病的高危人群。样本量是根据显著性水平为5%、把握度为90%、应答率约为90%的信息确定的。主要终点是2小时FPG降低10%，次要终点指标是饮食摄入量的改善。使用协方差分析对数据进行分析。结果：170例（91.9%）患者接受了治疗，其中88例接受了新型DE治疗，82例接受了传统DE治疗。1年时，新DE导致血糖控制显著改善，如2小时FPG（<0.001）和饮食摄入量（<0.001）所示。至于ITT，没有证据表明，获得的人数减少10%的2-h FPG.CONCLUSIONS：新的DE提供的营养师使用FFQ导致显着改善和有益的高危人群与2型糖尿病。

OBJECTIVE: To assess in a randomized controlled trial the effectiveness of dietary education to prevent Type 2 diabetes for a high risk patients of Japanese male workers.RESEARCH DESIGN AND METHODS: This study was a prospective, randomized,controlled clinical trial of two levels of dietary education (DE) in persons with new DE program or conventional DE. The goals of the new DE were to attain and maintain optimal blood glucose levels, to modify nutrient intake and lifestyle as appropriate for prevention, to address individual nutritional needs, taking into consideration personal and cultural preferences as while respecting the individual wishes and willingness to change, and to promote healthy food intake pattern. The study hypothesis was that the new DE might reduce 10% of 2-h fasting plasma glucose (2-h FPG) with a 1 and 6 month DE during 1 year.Data were collected at entry to the study and 1 year after. Subjects were 141 male workers aged over 35 years in a metropolitan area of JAPAN who diagnosed as a high risk group of Type 2diabetes. The sample size was determined based on the information with significant level of 5%, power of 90%, and response rate around 90%. Primary endpoint was 10% reduction of 2-h FPG and improvements of dietary intakes were secondary outcome measures. The data was analyzed using analysis of covariance. Intention to treat was examined using logistic regression analysis.RESULTS: The subjects for the analysis were 170(91.9%) individuals, 88 for new DE, 82 for conventional DE. At 1 year, the new DE resulted in significance improvements in blood glucose control as indicated by 2-h FPG (<0.001) and dietary intakes (<0.001). As for ITT, no evidence was obtained for number of persons with 10% reduction of 2-h FPG.CONCLUSIONS: The new DE provided by dietitians using FFQ resulted in significant improvements and beneficial to high risk persons with Type 2 diabetes.