Impact of Intensive Educational Approach to Dietary Change in NIDDM

The aim of this study was to compare the effects of an intensive educational approach incorporating longer time, greater simplicity, repetition, andcognitive motivational techniques with a conventional one in subjects with established non-insulin-dependent diabetes mellitus (NIDDM) whose weight, glycemic control, and diet were not optimal. Subjects were randomly allocated to intensive or conventional education. Of 350 subjects, 70 met the study criteria, which included established NIDDM (≥3 mo), suboptimal recent glycemic control, dietary fat intake ≥35% of total energy intake, and body massindex ≥25 kg/m². The intensive approach was associated with significantly greater improvements in dietary compliance, dietary intake (complex carbohydrate, [P = 0.013], legumes [P < 0.0001], fiber [P < 0.0001], total fat [P < 0.004], saturated fat [P < 0.004]), and total cholesterol level (P = 0.007). The transient improvement in glycemic control was similar in both groups. An intensive education program can improve dietary compliance in established NIDDM subjects more than a conventional one. These recommended dietary improvements achieve better improvement in total cholesterol but do not necessarily improve glycemic control.