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Kim, Kwon, and Ly: Effects of Low Glycemic Index Nutrition Education on the Blood Glucose Control in Patients with Type 2 Diabetes Mellitus
Original Article
Korean Journal of Nutrition

Korean Journal of Nutrition 2010; 43(1): 46-56.

Published online: 28 February 2010

DOI: https://doi.org/10.4163/kjn.2010.43.1.46

Effects of Low Glycemic Index Nutrition Education on the Blood Glucose Control in Patients with Type 2 Diabetes Mellitus

Mi-Ja Kim1, Sunja Kwon2, Sun Yung Ly1

1Department of Food and Nutrition, Chungnam National University, Deajeon 305-764, Korea.

2Department of Nutrition and Foodservice Management, Paichai University, Deajeon 302-735, Korea.

To whom correspondence should be addressed. (sunly@cnu.ac.kr)

Received 9 January 2010       Revised 25 January 2010       Accepted 4 February 2010

© 2010 The Korean Nutrition Society

Abstract

This study was intended to assess the effects of low glycemic index (LGI) nutrition education on dietary management and glycemic control of patients with type 2 diabetes mellitus. The subjects were 48 sex-matched patients with type 2 diabetes mellitus, aged 66.5 ± 6.2 years, visiting a public health center. They were divided into two groups: the control group (males 10, females 14) and the educated group (males 10, females 14). The educated group was provided with a LGI nutrition education program for 7 weeks. The control group was educated only one time for general diabetic education. Anthropometric indices, knowledge and perception of efficacy of low glycemic index carbohydrates, dietary glycemic index (DGI) and glycemic load (DGL), fasting blood glucose, and HbA1c were assessed. In the educated group body weight, body mass index and systolic blood pressure (from 138.0 ± 18.9 mmHg to 130.6 ± 15.0 mmHg) were significantly reduced after the nutrition education (p < 0.05). The scores of knowledge and perception of efficacy of low glycemic index carbohydrates increased significantly in the educated group. Dietary glycemic index and glycemic load of the educated group decreased significantly from 103.4 ± 67.6 to 45.4 ± 27.1 (p < 0.001), and from 173.3 ± 135.9 to 66.8 ± 50.4 (p < 0.001), respectively. Also fasting blood glucose and HbA1c levels of the educated group significantly decreased from 124.5 ± 28.8 mg/dL to 96.7 ± 21.6 mg/dL (p < 0.001) and from 7.1 ± 1.3% to 6.4 ± 1.2% (p < 0.05), respectively. The score of knowledge and perception of efficacy of low glycemic index significantly correlated with fasting blood glucose and HbA1c levels negatively. DGI, DGL and duration of diabetes significantly correlated with HbA1c level positively. From stepwise multiple linear regression analysis, DGI, DGL and the duration of diabetes were extracted as factors influencing HbA1c level of the subjects. The results of this study suggest that low glycemic index nutrition education programs is an effective intervention measure for the glycemic control in type 2 diabetic patients.

Keywords: diabetes mellitus, low glycemic index nutrition education, dietary glycemic index, dietary glycemic load, HbA1c

Figures and Tables

Table 1
General characteristics of the subjects
kjn-43-46-i001

1) N (%), 2) Mean ± SD, 3) Significantly different between groups by independent t-test, 4) Not significant

Table 2
Diabetes related characteristics of the subjects
kjn-43-46-i002

1) N (%), 2) Significantly different by chi-squre test: *: p < 0.05, 3) OHA: Oral Hypoglycemic Agent

Table 3
Anthropometric measurements of the subjects before and after nutrition education
kjn-43-46-i003

1) Mean ± SD, 2) Significantly different between groups by independent t-test: *: p < 0.05

Table 4
Changes in the scores of the knowledge and perception of efficacy of low glycemic index carbohydrates before and after low glycemic index nutrition education program
kjn-43-46-i004

1) Mean ± S.D.

2) Significantly different between groups by independent t-test. †: p < 0.05, ††: p < 0.01, †††: p < 0.001 N.S.: Not significant

3) Significantly different between pre and post education by paired t-test. *: p < 0.05, **: p < 0.01, ***: p < 0.001 N.S.: Not significant

Table 5
Changes of dietary glycemic index and glycemic load of the subjects' diet according to low glycemic index nutrition education
kjn-43-46-i005

1) Mean ± S.D., 2) Significantly different between pre and post education by paired t-test. ***: p < 0.001

3) Significantly different between groups by independent t-test. †††: p < 0.001

4) DGI: dietary glycemic index, 5) DGL: dietary glycemic load

Table 6
Changes of fasting blood glucose and HbA1c after low glycemic nutrition education
kjn-43-46-i006

1) Mean ± SD

2) Significantly different between pre and post education by paired t-test *: p < 0.05, ***: p < 0.001

Table 7
Pearson's correlation coefficients between fasting blood glucose or HbA1c and general and diet related variables of the subjects
kjn-43-46-i007

1) *: p < 0.05, **: p < 0.01, 2) DGI: dietary glycemic index, 3) DGL: dietary glycemic load

Table 8
Stepwise multiple linear regression analysis of factors related to HbA1c concentrations in subjects
kjn-43-46-i008

1) DGI: dietary glycemic index, 2) DGL: dietary glycemic load

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