Effectiveness of and Adherence to Dietary and Lifestyle Counselling : Effect on metabolic control in type 2 diabetic Omani patients

Abstract

Objectives: The Nutritional Advice Protocol, established by the Department of Health to combat diabetes, has been implemented in primary health care throughout Oman since 2003. This study aimed to assess the effectiveness of dietary and lifestyle advice and determine the perception and attitudes of Omani adults with type 2 diabetes to diabetes management. Methods: A cross-sectional epidemiological survey was conducted on 98 patients diagnosed with type 2 diabetes in Al-Buraimi Governorate, Oman. Metabolic parameters, dietary intake and exercise levels were evaluated in 2005 and re-evaluated in 2008. Results: A total of 43% of the patients (male = 16, female = 27) had received no formal education. A significant reduction in fasting glucose and enhanced high density lipoprotein cholesterol were achieved in both male and female patients. However, in men, no changes were noted, other than in anthropometric and metabolic measurements and macronutrient intake. Conversely, women’s macronutrient intakes reduced significantly leading to considerable improvement in body weight, body mass index, blood glucose and total cholesterol levels. Eleven patients (11.6%) admitted that they did not adhere at all to the diet advised by the dietician; 63.2% (n = 62) reported they followed their diet sometimes, and 25.2% (n = 25) stated they strictly followed the diet. Conclusion: Counselling largely illiterate diabetic patients about the impact of food, nutrition and exercise on diabetes shifted the patients from “Poor” to “Good” control in terms of metabolic outcome (glycosylated haemoglobin, fasting glucose and total cholesterol). This minor improvement could be further enhanced by more health education.