| Objective:To assess the glycemic index (GI) knowledge, diet and quality of life status of the Type 2 Diabetes (T2DM) patients in community; To evaluate the effects of the LGI and LGL diet intervention on blood glucose, lipids and other metabolic items, GI Knowledge awareness, diet, quality of life of T2DM.Methods:This study was a randomized control study. There were 105 patients with T2DM were selected to be samples from JinPenling Sanzhen community, Changsha city. The clients were divided into three groups randomly:the whole day group (n=35), the breakfast group (n=35) and the control group (n=35). Interventions included clients educations and different dietary. The whole day group and the breakfast group were educated with the knowledge of the GI and the glycemic load (GL). Furthermore, we made the personal dietary of the whole day based on low glycemic index (LGI) and low glycemic load (LGL) for the whole day group; we made the personal dietary of the breakfast based on LGI and LGL for the breakfast group, the other meals of this group were chosen themselves; The program gave the control group without any intervention in this study. Before and after intervention, the workers collected the basic informations of three groups; compared their body weight, waist circumference(WC), hip circumference(HC), BMI, waist-hip ratio, fasting blood glucose (FBG), postprandial 2h blood glucose (2hPBG), glycosylated hemoglobin (HbAlc), triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL-CH), low density lipoprotein (LDL-CH), fasting C peptide, HOMAL-IR; compared the differences of the GI knowledge questionnaires, dietary record sheets and specific quality of life questionnaire (DSQL). According to the comparison between the groups and the group themselves, we can evaluate the effects LGI and LGL diet intervention on metabolic control in patients with T2DM and influences on their quality of life. All the informations were analyzed by SPSS17.0.The statistics methods included descriptive analysis, t-test, x'test, rank sum test, rank correlation, et al. All statistical tests were two sided with a of 0.05. Results:1. Awareness rate of GI Knowledge:Before the intervention, the mean rate of GI was 57.74%, which was low. There were 93.75% of the clients thought that controlling glucose in a relative stable status was very important. But,17.71% of them knew the GI concept; 31.25% of them thought the LGI diet can control blood glucose more stable; 30.21% of them though that the HGI can be used to relief hypoglycemia; The rates of other four questions were more than 70%.2. The changes of diet situation:Before the intervention, the average GI value of each meal was a little high with 69.71±8.55, the value of all-day GL diet was 132.45±16.25, oil consumption was high with 39.95±20.64g per-day.3. Quality of Life:Before the intervention, the total score of quality of life was 59.58±16.32, physiological dimension score was 27.93±8.32, psychological dimension score was 18.82±5.45, social dimension score was 7.06±2.83, treatment dimension scores was 5.77±1.97. The mean physiological dimension score was the highest.4. Changes of GI knowledge after the intervention:In the whole day group, the mean awareness rate of the seven questions was 96.31%; In the breakfast group, the mean awareness rate of the seven questions was 94.54%. The correct rate of the control group did not change (P>0.05). The whole day group and the breakfast group had more significant changes than the control group. The awareness rates of questions "knew the GI concept", "thought that the LGI diet can control blood glucose more stable", "thought that the HGI can be used to relief hypoglycemia", "though that the different kinds of food processing or cooking can cause different effects in glucose" were raised (P<0.0125) in the whole day group and the breakfast group;The awareness rate of question "the grain would caused larger fluctuation in blood sugar" in the whole day group was higher than the control group (P<0.0125)5. The effects of the intervention on diet situation:The changes of oil consumption in the whole day group had significant differences than the breakfast group and the control group (P<0.0167).There were differences among any two of the three groups in the GI value (P<0.0167). The changes of GL values in the whole group than in the breakfast group and the control group (P<0.0167)6. Changes of quality of life scores:The changes of the social dimension (P<0.05) and treatment dimension (P<0.01) among three groups had significantly differences. The changes of social dimension in the whole group had differences with the breakfast group (P<0.0167) The changes of treatment dimension in the whole group had differences with the breakfast group and the control group (P<0.0167).7. Changes in metabolic items:The weight and BMI of the whole day group were changed more than the control group (P<0.0167).The WHR of the the whole day group were changed more than the breakfast group (P<0.0167). The DBP of the the whole day group were changed more than the control group (P<0.0167). The HbAlc.HDL-CH of the the whole day group were changed more than the breakfast group and the control group (P<0.0167). The TG of the the whole day group and the breakfast group were changed more than and the control group (P<0.0167).Conclusion:1. T2DM clients at community were lack of GI knowledge whose awareness rate of some questions was low.2. The mean GI of all meals were at medium to high level; oil consumption per-day was at a high lever.3. The total quality of life scores and each dimensions were low, which Physical dimension was the lowest.4. LGI and LGL dietary intervention was effective on blood glucose and lipid control, the whole day dietary intervention was more effective than the breakfast intervention; GI health education can effectively improve the patient's awareness of the GI diet knowledge; The intervention improves quality of life of T2DM patients like their society relationship and the treatment. |
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