Community-based Nutritional Management for Secondary Prevention of Diabetic Macrovascular Diseases

Hye Jin Lee; Jung Jeung Lee

doi:10.4093/jkd.2013.14.1.36

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Lee and Lee: Community-based Nutritional Management for Secondary Prevention of Diabetic Macrovascular Diseases

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J Korean Diabetes 2013;14(1):36-41.

Published online: 7 January 2013

DOI: https://doi.org/10.4093/jkd.2013.14.1.36

Community-based Nutritional Management for Secondary Prevention of Diabetic Macrovascular Diseases

Hye Jin Lee¹, Jung Jeung Lee²

¹KHyDDI (Korea Hypertension Diabetes Daegu Initiative) Project, Education Center, Daegu, Korea

²Department of Preventive Medicine School of Medicine, Keimyung University, Daegu, Korea

교신저자: 유주화, 서울시 종로구 대학로 101 서울대학교병원 내분비내과 병동, E-mail: jjlee@dsmc.or.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Community health projects focusing on secondary prevention of diabetic macrovascular diseases have become increasingly common. In Daegu, Korea, a metropolitan hypertension diabetes management project has been developed in which community primary physicians refer clinic patients to education centers or clinical education teams for target education on lifestyle modification through technology-based information networks. Call centers provide information on lifestyle management and encourage continuous treatment through periodic calls and SMS. Integrative education is presented by doctors, dietitians, exercise specialists, and nurses. This project was developed in response to an educational need study of patients and educators. Patients participating in the program showed significant improvement in both self-efficiency and in clinical outcomes.

Keywords: Nutrition therapy, Diabetes mellitus, Education

REFERENCES

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2. SDaegu Metropolitan City, Korea Centers for Disease Control and Prevention, Ministry for Health, Welfare and Family Affairs. KHyDDI (Korea Hypertension Diabetes Daegu Initiative) Project Report. Daegu: Daegu Medical Association;2011.

3. SKyungpook National University Hospital, Korea Centers for Disease Control and Prevention, Ministry for Health, Welfare and Family Affairs. Regional cardiocerebrovascular disease center manual. Daegu: Daegu Medical Association;2011.

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Table 1.

KHyDDI Staged Education Program

Session	Stage/Subject	Aspect/Educator	Objectives	Methods	Contents	Time (min)
1	Basic/ Beginner Poor-controller Poor controller 3 months after	Total/ Nurse, dietitian, exercise specialist	Knowledge of risk factor	Individual	Cardiocerebrovascular disease risk factor screening (20 min) Measurement (body composition, weight, waist circumference, blood sugar/pressure) (10 min)	30
2		Disease/ Doctor, nurse (practice)	Knowledge of management introduction Motivation	Group: lecture 50% practice 50%	Easy hypertension/diabetes class Introduction (30 min) Self-monitoring practice: blood pressure/sugar, waist circumference (30 min)	60
3		Nutrition/ Dietitian			Easy diet class ·Introduction (30 min) ·Rice amount,/salty taste assessment (30 min)	60
4		Exercise/ Exercise specialist			Easy exercise class ·Introduction (30 min) ·Senior test, stretching (30 min)	60
5	In-depth/ ·Within 1 mon after basic	Nutrition/ Dietitian	Practice of self-management skill	Small group: lecture 30% practice 70%	My Diet (lecture 30 min, practice 60 min) 1) Balanced/proper eating 2) Non-salty eating	90
6	Poor controller Poor controller 3 mon after	Exercise/ Exercise specialist			My Exercise (lecture 30 min, practice 60 min) 1) Right walking	90
7		Nutrition, Exercise/ Dietitian, exercise specialist			2) Right weight lifting Diet demonstration program (lecture 30 min, practice 120 min) 1) My meal demonstration 2) My exercise demonstration	180
8	Individualized ·Every 3 mon after basic /In-depth ·Poor controller in advanced ·3 mon participants ·In special conditions	Nutrition, Exercise/ Dietitian, exercise specialist	Problem-solving competence & continuous self-management skills	Individual/ Lecture70% Practice30%	Individualized nutrition and exercise ·Individual lifestyle assessment problem-solving (40 min) ·Goal-setting, planning demonstration (20 min)	60

KHyDDI, Korea Hypertension Diabetes Daegu Initiative.

^∗ Salty Taste Material by Daegu Metropolitan City Salt Reduction Project (Patent no. 10-2007-0116957).

Table 2.

KHyDDI Nutrition Education Practice Program

Session Subject	Program activities	Type of teaching	Educational materials	Time (min)
1 Eat slightly salty	Introduction Salty taste assessment^∗ Survey (nutrition knowledge, dietary behavior, food record) Sodium intake and diseases Cooking practice - Salinity comparison of salt products - Salinity preference of soup - Soy sauce usage by cooking method: roasting and jorim	Lecture Cooking	PPT Cooking practice	150
2 Eat regularly	Food intake by 24 hr recall method Balanced and regular diet 3 major nutrients 6 kinds of food group Sick day meal Cooking practice - healthy porridge	Lecture Cooking	PPT Cooking practice	120
3 Eat slightly fat	Food intake by 24-hr recall method Proper fat intake Cholesterol Saturated fatty acid Unsaturated fatty acid Cooking practice - Oil usage by cooking method: roasting and frying	Lecture Cooking	PPT Cooking practice	120
4 I can do it myself	Salty taste assessment^∗ Survey (nutrition knowledge, dietary behavior, food record) Meal amount prescription Cooking practice - Meal planning - Healthy food choice - Self-cooking - Healthy diet discussion Certification	Lecture Cooking	PPT Cooking practice	150

KHyDDI, Korea Hypertension Diabetes Daegu Initiative.

^∗ Salty Taste Material by Daegu Metropolitan City Salt Reduction Project (Patent no. 10-2007-0116957).

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