Barriers to adherence to a nutritional plan and strategies to overcome them in patients with type 2 diabetes mellitus; results after two years of follow-up

Autor: Héctor Rafael Velázquez-Jurado, Fabiola Mabel Del Razo-Olvera, Ana Cristina García-Ulloa, María Victoria Landa-Anell, Sergio Hernández-Jiménez, Marco Antonio Melgarejo-Hernández
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
Time Factors
Endocrinology
Diabetes and Metabolism
media_common.quotation_subject
Psychological intervention
030204 cardiovascular system & hematology
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Endocrinology
Denial
Patient Education as Topic
Intervention (counseling)
Surveys and Questionnaires
Diet
Diabetic
medicine
Humans
In patient
Body Weights and Measures
Medical nutrition therapy
Prospective Studies
Prospective cohort study
Mexico
Triglycerides
media_common
Glycated Hemoglobin
030109 nutrition & dietetics
Nutrition and Dietetics
Health professionals
business.industry
Type 2 Diabetes Mellitus
Middle Aged
Diabetes Mellitus
Type 2
Physical therapy
Patient Compliance
Female
Information Literacy
business
Follow-Up Studies
Zdroj: Endocrinologia, diabetes y nutricion. 67(1)
ISSN: 2530-0180
Popis: Introduction Lifestyle changes in medical nutrition therapy (MNT) are associated to HbA1c decreases ranging from 0.3 to 2%. Evidence shows that people with barriers are less likely to adhere to a long-term nutritional plan. Little information is available on the barriers that prevent the implementation of a healthy nutritional plan, and the strategies used to overcome them. Objective To report the longitudinal changes in perceptions of barriers to adherence to a nutritional plan in T2DM. Methods A prospective cohort study with intervention. Follow-up was assessed at two years, and all patients received comprehensive care according to the CAIPaDi model. A questionnaire was used to detect the most common barriers to adherence to a nutritional plan at baseline and at 3 months and 1 and 2 years of follow-up. The analysis included data from 320 patients with complete evaluations from baseline to 2 years. Patients with T2DM aged 53.8 ± 9.1 years (55.9% women), BMI 29.2 ± 4.4 kg/m2, and time since the diagnosis 1 (0–5) years were included in the study. Results At baseline, 78.4% of patients reported any barrier that limited adherence to a nutritional plan. The most common were “Lack of information on an adequate diet” (24.7%), “I eat away from home most of the time” (19.7%), and “Denial or refusal to make changes in my diet” (14.4%). After a structured nutritional intervention including strategies to eliminate each barrier, a 37% reduction (p 7% (24.7%) and triglyceride levels >150 mg/dL (27.5%) out of the control range as compared to those with no barriers (11.6% and 14.4% respectively, p Conclusions Identification of barriers to adherence to a nutritional plan may allow healthcare professionals design interventions with the specific behavioral components needed to overcome such barrier, thus improving adherence to the nutritional plan with the resultant long-term changes.
Databáze: OpenAIRE
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