Effectiveness of Restricted Diet with a Plate in Patients with Type 2
Diabetes: a Randomized Controlled Trial
Abstract
Aims: To evaluate whether the plate model can effectively improve
glycemic control and cardio-vascular risk markers in type 2 diabetes
mellitus (T2DM), while reducing the time devoted to edu-cation and
avoiding weight gain. Methods: The study included 419 participants who
were randomly divided into a plate group and a counting group. The plate
model included three components: a low-literacy, color leaflet
containing the explanation and composition of the plate model, health
education, and medical visits. Patients in the counting group received
health education, group medical visits, and a paper booklet containing
traditional carbohydrate counting education. Primary outcomes were
glycemic control and weight. Results: Participants in the plate model
reduced HbA1c by 0.7% in the first three months, and re-duced to a
greater extent at six months (1.44%), but this was not sustained, and
HbA1c increased slightly over the following six months. Fasting plasma
glucose (FPG) and 2-h postprandial glucose (2hPG) values were
significantly reduced at the endpoint in the plate model (9.25 ± 1.72%
vs. 7.44 ± 0.88%, P=0.008; 12.07 ± 2.94 vs. 8.35±1.99%; P=0.004);
however, the 2hPG values decreased most significantly. Total cholesterol
(TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased
significantly in the plate group, which occurred at six months and
lasted for 12 months. Conclusions: The plate model is more effective
than counting education, associated with less weight gain, allows
dietary freedom to most of patients, promotes behavior change, and
requires less time for education. Plate model has the potential to
improve education of those with low health literacy by reducing reading
demands.