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- Title
Diet self-management and control of glycated hemoglobin A1c in patients with type 2 diabetes mellitus.
- Authors
Zhu Haiqing; Yang Qianqian; Wang Bing; Wang Kailiang; Han Yang; Sun Yan; Zhang Yan; Li Hongmei
- Abstract
Objective To investigate the influencing factors of diet self-management and its relationship with glycated hemoglobin A1c (HbA1c) control in patients with type 2 diabetes mellitus (T2DM). Methods A total of 275 patients with T2DM in four hospitals in Chaoyang District of Beijing were investigated by WeChat questionnaire and face-to-face questionnaire, and the dietary behavior compliance scale for patients with T2DM (including total score and scores of five dimensions: diet self-regulation, sugar and fat compliance behavior, oil and salt compliance behavior, fruit and vegetable compliance behavior, cooking and eating habits) was used to evaluate their dietary self-management. The weight classification was based on the Chinese adult body mass index (BMI) proposed by the World Health Organization classification. The receiver operating characteristic (ROC) curve was established for 275 subjects to test the diagnostic cut-off point between the total score of patients' dietary compliance and HbA1c. The cut-off score of dietary compliance was 80.5, with the highest Jordan index (0.240). The patients were divided into two groups: compliance with diet management group (98 cases) and non-compliance with diet management group (177 cases). Two hundred and four patients provided the latest HbA1c results in recent 3 months, 69 cases (33.8%) met the standard (HbA1c<7% group) and 135 cases (66.2%) failed to meet the standard (HbA1c≥7% group). The measurement data in line with normal distribution were analyzed by t-test between the two groups. The comparison of classified data was analyzed by Chi square test or Fisher exact probability method. Multivariate logistic regression and multiple linear correlation analysis were used to analyze the influencing factors affecting patients' dietary self-management and HbA1c compliance. Results Among 275 subjects, 115 cases (41.8%) were overweight and 46 cases (16.7%) were obese. There were more women and lower rates of overweight and obesity in the HbA1c<7% group than those in the HbA1c≥7% group (all P<0.01). Women and the patients with BMI<24 kg/m2 had higher percentage of compliance with diet management (P<0.01). Multivariate logistic regression analysis showed that women and the patients with BMI<24 kg/m2 were correlated with better dietary compliance. Patients were stratified according to gender and BMI, and the scores of dietary compliance in five dimensions were compared. The results showed that patients with BMI<24 kg/m² had higher scores in all aspects and total dietary compliance than those with BMI≥24 kg/m² (P<0.05). Females had higher scores than males in other four dimensions of diet compliance behaviors (all P<0.05) except for the score of dietary self-regulation (P>0.05). The total score of dietary compliance of the HbA1c<7% group was higher than that of the HbA1c≥7% group [(82.0±12.4) vs. (75.6±12.9) points, P=0.001]. Among the five dimensions of dietary compliance, except cooking and eating habits (P>0.05), the scores of other four dimensions were all higher than those of the HbA1c≥7% group (all P<0.05). Multivariate analysis showed that BMI<24 kg/m2 (OR=3.007, 95%CI 1.525-5.928) and self-management of diet (OR= 3.003, 95%CI 1.305-6.912) were related to HbA1c<7%. The results of multiple linear regression showed that there was a negative correlation between education level (β=-0.175, P=0.022), dietary compliance score (β=-0.162, P=0.026) and HbA1c level. Conclusions The percentage of overweight and obesity of the participants is high, and the percentage of HbA1c <7% is low. Female and patients with BMI<24 kg/m² are the factors of good dietary self-management compliance. BMI<24 kg/m² and self-management of diet are the factors of HbA1c<7%. Patients with higher education level and dietary compliance score have lower HbA1c level.
- Publication
Chinese Journal of Diabetes Mellitus, 2021, Vol 13, Issue 12, p1123
- ISSN
1674-5809
- Publication type
Article
- DOI
10.3760/cma.j.cn115791-20210606-00314