Procjena učinka nutritivne intervencije na regulaciju glikemije i lipidnoga profila u osoba oboljelih od šećerne bolesti tipa 2

The purpose of this work was to: (i) determine the impact of nutritional intervention in persons with type 2 diabetes on the regulation of glycaemia (plasma glucose, glycated hemoglobin HbA1c), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) and anthropometric parameters (weight and body mass index - BMI) (ii) determine the relationship between dietary habits and knowledge about nutrition in type 2 diabetes and their influence on the regulation of glycemia and lipid profile during the twelve months follow-up, (iii), analyse hospital menus and determine adequate food composition database for diet planning in diabetes, (iiii) validation of a nutrition knowledge questionnaire for patients with diabetes. The study included 160 patients with non-regulated type 2 diabetes (HbA1c > 7.5 %), median age 61.8 ± 8.5 years, BMI 32.57 ± 6.48 kg/m² and disease duration 10.9 ± 7.6 years. All subjects have participated in an intensive 5-day program in daily hospital, involving education and nutritional intervention, followed by three follow-up visits after 3, 6, and 12 months. A validated questionnaire was used to determine knowledge about nutrition in diabetes and dietary habits were monitored through patient’s selection of menus from diabetic, Mediterranean or higher-carbohydrate diets. The study showed that nutritional intervention had a statistically significant effect on lowering concentrations of HbA1c (p <0.001); plasma glucose (p = 0.003); LDL cholesterol (p = 0.022); triglycerides (p = 0.019) and total cholesterol (p = 0.021) during the observed period. At the end of the study, there was a statistically significant increase the number of patients (10.3 vs. 23.1 %; p <0.05) with normal weight (BMI < 25 kg/m²) and a decrease in the number (64.5 vs 53, 8 %, p < 0.05) of obese patients (obese class I, II, III) in the examined sample. It was found that dietary habits correlate with the biochemical parameters of the patients at the beginning, during the follow-up period and at the end of the study. In patients who chose menus of the Mediterranean diet the most during the five-day education, after three, six and twelve months they had the lowest values of all biochemical parameters compared to other patients (p < 0.05). There was a statistically significant (p < 0.05) influence of nutritional intervention on changing dietary habits and knowledge about nutrition in patients with type 2 diabetes, and the influence on the decreasing levels of HbA1c and lipid profile. The study found that nutritional intervention, which includes education, testing of knowledge about nutrition and eating habits, results better regulation of diabetes, established reduction of HbA1c and has a beneficial effect on weight loss and lipid profile in patients with diabetes type 2. The obtained results increase the understanding how education and knowledge about nutrition enable better control of diabetes type 2.