medigraphic.com
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2010, Number 3

<< Back Next >>

Rev Invest Clin 2010; 62 (3)

Adherence to a medical nutrition therapy program in pregnant women with diabetes, measured by three methods, and its association with glycemic control

Balas-Nakash M, Rodríguez-Cano A, Muñoz-Manrique C, Vásquez-Peña P, Perichart-Perera O

Language: Spanish
References: 31
Page: 235-243
PDF size: 77.05 Kb.


ABSTRACT

Introduction. The measurement of adherence to nutrition therapy is essential to evaluate if the outcomes are related to given recommendations. Material and methods. The aim of this study was to describe adherence to a Medical Nutrition Therapy Program in Mexican pregnant women with diabetes, using three different methods; and evaluate its association with glycemic control. Adherence was measured with a questionnaire (0-100%), women’s self-perception (0-100%) and energy intake adequacy by multiple pass 24 hour recall (85-115% of recommendation). Women were randomly assigned to two different dietary strategies. Glycemic control was determined by capillary glucose self-monitoring. Results. Women analyzed in this study (n = 69) had an age range of 22-42 years; 47.8% had type 2 diabetes (DM2) and 52.2% had gestational diabetes (GDM). Energy intake adequacy was higher in women with GDM (41.9% vs. 37.7%, p = 0.001). Average adherence measured with the questionnaire was 55%; no differences were found by type of diabetes. Self-perception was higher in women with DM2 (84%) when compared to women with GDM (70%) (p = 0.039). No differences were found in the three methods by study group. Optimal glycemic control was observed in 50% of women; no association was found with adherence measured with any of the three methods studied. Conclusions. The observed differences in adherences suggest that it may be recommendable to combine different measurement methods and include social and psychological factors that affect behavioral change.


REFERENCES

  1. Olaiz G, Rivera J, Shamah T, Rojas R, Villalpando S, Hernandez M, et al. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México; Instituto Nacional de Salud Pública; 2006.

  2. American Diabetes Association Position Statement: Gestational Diabetes Mellitus. Diabetes Care 2004; 27(Suppl. 1): S88-S90.

  3. Joint WHO/FAO Expert consultation. Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. Geneva, Switzerland: 2002.

  4. Forsbach G, Vázquez-Lara, Alvarez J, García C, Vázquez-Rosales J. Diabetes y embarazo en México. Rev Invest Clin 1998; 50(3): 227-31.

  5. Jovanovic L. Role of diet and insulin treatment of diabetes in pregnancy. Clin Obstet Gynecol 2000; 43: 46-55.

  6. Jovanovic L. Medical nutritional therapy in pregnant women with pregestational diabetes mellitus. J Mat Fet Med 2000; 9: 21-8.

  7. American Dietetic Association. Medical Nutrition Therapy: Nutrition Practice Guidelines for Gestational Diabetes. USA; 2001.

  8. Perichart-Perera O, Balas-Nakash M, Parra-Covarrubias A, Rodríguez- Cano A, Ramírez-Torres MA, et al. A medical nutrition therapy program improves perinatal outcomes in Mexican pregnant women with gestational diabetes and type 2 diabetes. Diabetes Educ 2009; 35(6): 1004-13.

  9. Koenisberg RM, Bartlett D, Cramer JS. Facilitating treatment adherence with lifestyle changes in diabetes. American Family Physician 2004; 69(2): 309-16.

  10. Delamater AM. Improving patient adherence. Clinical Diabetes 2006; 24(2): 71-7.

  11. World Health Organization. Adherence to long term therapies. Evidence for action. Geneva, Switzerland; 2003.

  12. Reader DM. Medical Nutrition Therapy and Lifestyle Interventions. Diabetes Care 2007; 30(Suppl. 2): S188-S193.

  13. Tillotson LM, Shelton-Smith MS. Locus of control, social support, and adherence to the diabetes regimen. Diabetes Educ 1996; 22: 133-9.

  14. Nelson KM, McFarland L, Reiber G. Factors influencing disease self-management among veterans with diabetes and poor glycemic control. SGIM 2007; 22: 442-7.

  15. Travis T. Patient perceptions of factors that affect adherence to dietary regimens for diabetes mellitus. Diabetes Educ 1997; 23: 152-6.

  16. Lerman L, Lozano L, Villa A, Hernández-Jiménez S, Weinger KA, Caballero E, et al. Psychosocial factors associated with poor diabetes self-care management in a specialized Center in Mexico City. Biomed Pharmacother 2004; 58(10): 566-70.

  17. Monroy-Torres R, Reeves-Aguirre CC, Naves-Sánchez J, Macías AE. Influencia de una dieta individualizada en el control de la diabetes mellitus gestacional. Ginecol Obstet Mex 2008; 76(12): 722-9.

  18. Freinkel N. Summary and recommendations of the second International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes 1985; 34(Suppl. 2): S123-S126.

  19. Conway J, Ingwersen L, Vinyard B, Moshfegh A. Effectiveness of the US Department of Agriculture 5-step multiple pass method in assessing food intake in obese and nonobese women. Am J Clin Nutr 2003; 77: 1171-8.

  20. Chavez M, Hernandez M, Roldan J. Tabla de uso practico del valor nutritivo de los alimentos de mayor consumo en México. Comisión Nacional de Alimentación. México. Instituto Nacional de la Nutrición Salvador Zubirán; 1992.

  21. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure. Diabetes Care 2000; 23(7): 943-50.

  22. Ruggiero L, Spirito A, Coustan D, McGarvey ST, Low KG. Self reported compliance with diabetes self management during pregnancy. International Int J Psychiatry Med 1993; 23(2): 195-207.

  23. Taddeo D, Egedy M, Frappier JY. Adherence to treatment in adolescents. Paediatr Child Health 2008; 13(1): 19-24.

  24. Willet W. Nature of variation in the diet. In: Willet W, editor. Nutritional Epidemiology. New York: Oxford University Press; 1998. p. 33-49.

  25. Ary DV, Toobert D, Wilson W, Glasgow R.E. Patient perspective on factors contributing to non-adherence to diabetes regimen. Diabetes Care 1986; 9: 168-72.

  26. Wen LK, Parchman ML, Shepherd MD. Family support and diet barriers among older Hispanic adults with type 2 diabetes. Fam Med 2004; 36: 423-30.

  27. Rustveld LO, Pavlik VN, Jibaja-Weiss ML, Kline N, Gossey JT, Volk RJ. Adherence to diabetes self-care behaviors in Englishand Spanish-speaking Hispanic men. Patient Preference and Adherence 2009; 3: 123-30.

  28. Wooldridge KL, Wallston KA, Graber AL, Brown AW, Davidson P. The relationship between health beliefs, adherence, and metabolic control of diabetes. Diabetes Educ 1992; 18(6): 495- 500.

  29. Krupa DS, Gilhooly CH, Golden JK, Pittas AG, Fuss PJ, Cheatham RA, et al. Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial. Am J Clin Nutr 2007; 85: 1023-30.

  30. Burani J, Longo PJ. Low glycemic index carbohydrates: an effective behavioral change for glycemic control and weight management in patients with type 1 and 2 diabetes. Diabetes Educ 2006; 32(1): 78-88.

  31. Kurtz MS. Adherence to diabetes regimens: empirical status and clinical applications. Diabetes Educ 1990; 16: 50-5.




2020     |     www.medigraphic.com