The Effective Of Individualized Medical Nutrition Therapy And Health Education Under The Community Dietitians

Objective To explore the effect by health education, individualized medical nutrition therapy and cereal meal about the Type 2 diabetes and training patients to develop good eating habits and improve the skills by self-regulation in diet. Provide a theoretical basis for the diabetes in community control flow by the nutrition intervention and education.Methods From 50 communities to select three with a high degree in Yinchuan.Within the community to select 240 cases of T2 DM patients as a volunteer for the study,then using software to evaluate the nutritional status in patients and measuring blood biochemical indexes such as FPG in patients to evaluation the status quo. The evaluation about two interventions(the intervention like individualized nutritional therapy and(or) cereal of eating) is used factorial design method and based on community health education for patients. To study the effects on patients' blood sugar, glycosylated hemoglobin control situation after 80 days under the intervention.Results The elderly patients with type 2 diabetes self-management level average was(3.27 ± 1.15) points, the self-management level in general accounts for 61.9% of the total, while higher levels of self-management of the total number of patients accounted for only 7.6%; 240 cases of patients diabetes-related knowledge score was 49.65 percent, general knowledge and knowledge of balanced nutrients accounts for 59.85% and 65.45%, while the correct rate about knowledge of the food exchange method, the total energy control and glycemic index low of 24.68%, 36.67% and 37.04%.Glycemic control in 240 patients with fasting blood glucose control in patients was 37.5%, while the Hb A1 c control rate was only 26.3%. The patient's age(OR = 0.952), family history(OR = 1.917), duration(OR = 1.870) and self-management behavior score(OR = 0.54) are will impact on glycated hemoglobin control; the patient's energy, protein, calcium, zinc, vitamins and other nutrients and dietary fiber intake were below the recommended intake(RNI) value(P<0.05), cholesterol and iron intake near the RNI value. The patients has inadequate intake in various nutrients. The average of FBG in 240 patients after the intervention is lower than before the intervention(P<0.05), but the FBG control rate in patients with no statistically differences(P>0.05). There were differences(P<0.05) between four groups after the intervention about Hb A1 c.Factorial design analysis of variance showed, individualized nutrition therapy for patients with FBG has obvious therapeutic effect(P<0.05), cereal meal eaten alone had no significant treatment effect(P>0.05), and there were no interaction between two interventions(P>0.05).The mean Hb A1 c after the intervention in diabetic patients was significantly lower than before intervention(P<0.05), and after the intervention patients' Hb A1 c control rate was 48.5% higher than the control rate of 26.3% before the intervention(P<0.05). The patients just eat the cereal flour for Hb A1 c had no significant treatment effect(P>0.05).The individualized nutrition therapy can effectively improve the patient's Hb A1 c level(P<0.05)and there were interactions between the two interventions(P<0.05). Under the individual nutrition therapy measures and eating the cereal meal can better improve the patient's Hb A1 c control.Conclusion T2 DM patients self-management status in general, the management situation about blood sugar monitoring is lower. Patients have some diabetes' knowledge, but knowledge of nutrition therapy cognitive are lower; T2 DM patients in diet structure is irrational before the intervention; The Hb A1 c in patients with a lower control rate and is affected by age, family history, course and SDSCA rates and other factors. The individualized nutrition therapy interventions by the based on community participation with dietitians has an important role in control blood sugar and glycosylated hemoglobin. A combination with eating cereal flour and individualized nutrition therapy can improve the patient's glycated hemoglobin control can provide reference for the community comprehensive diabetes prevention and treatment. This study can provide a reference basis for community comprehensive prevention and control of diabetes.