Supervisors info:
Τεντολούρης Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κόκκινος Αλέξανδρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μακρυλάκης Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Rational: The dietetic intervention is crucial to diabetes care. This retrospective study examined the significance of dietetic consultation and the adherence to the Mediterranean Diet in weight loss and glycemic control in people with type 2 diabetes (T2DM).
Methods: A total of 146 T2DM patients (88 male and 58 female) with mean age 62 ± 7,9 years were retrospectively observed for 10 years (2009-2019 and 2010-2020).The initial body mass index (BMI) was 30,75 ± 5,6 kg/m2, the body weight was 86,09 ± 18,14 kg and the initial glycated hemoglobin (HbA1c) was 7,52 ± 1,58%.The median duration of diabetes was 14,56 ± 7,4 years. Patients who did not have at least 2 visits/year at the outpatient clinic were excluded from the study. In a subgroup of 94 patients, the we calculated the MedDietScore after an interview and we recorded if the patients had consulted a dietitian while being treated for diabetes. The data were processed in SPSS statistics.
Results: The median number of visits/year was 2,67 (2,2-3). The mean MedDietScore was 35,56 ± 3,37. 66% of the subjects had consulted a dietitian, while 34% had not. In the 5-year-follow-up period there was observed statistically significant weight loss (p<0,001), as well as in the 6 and 8-year-follow-up (p=0,045, p=0,048). This weight reduction diminished the following years. The weight loss which occurred from the first to the last visit of the 146 subjects was -3,02 ± 8,71 kg (p<0,001). Women lost more weight in comparison with men (p=0,038). The HbA1c was found reduced by 0,96 ± 1,54% in the first 5 years (p<0,001) and the reduction was preserved until the 9th year of follow-up. Greater HbA1c reduction was observed to those who lost weight (p=0,027), while no correlation was found between the adherence to the Mediterranean Diet and the weight change or the HbA1c. Multivariate logistic regression analysis demonstrated that the antidiabetic treatment did not affect the body weight change.
Conclusion: The study showed that over time there is small weight loss and better glycemic control in T2DM patients, independently of weight loss. The patients had a high adherence to the Mediterranean Diet. Despite the dietetic and nutritional education and consultation being considered necessary in T2DM treatment, not all patients visit a dietitian although they are advised to.
Keywords:
Diabetes, Obesity, Dietitian, Mediterranean diet, Weight loss
