INTRODUCTION: Dietary intervention remains an important factor in the management of diabetes mellitus, and many patients have employed herbs and oils to help manage their chronic diseases. Extra virgin olive oil (EVOO) is widely known for its cardio-vascular benefits. However, its effect on the blood glucose of type 2 diabetes mellitus patients has not been extensively studied. In this study, we aimed to determine if the addition of EVOO to meals results in a lower postprandial blood glucose among type 2 diabetes mellitus patients. METHODS: Thirteen patients were included in this randomized controlled cross-over trial. They were randomized to receive a meal with or without EVOO followed by a one week washout period, where they were given the other intervention. The primary outcome is the trans-meal blood glucose, which was calculated as the percent change in two-hour postprandial blood glucose. RESULTS: In group A, there was a noted 88.55% increase in two-hour postprandial blood glucose in taking meals with EVOO, versus 72.11% change in meals without EVOO. The same was observed in Group B, with a 71.08% and 49.22% increase in two-hour postprandial blood glucose in meals with EVOO and without EVOO, respectively. The difference was significant with a p-value of 0.044. Free fatty acids inhibit glucose transport and insulin secretion, this effect may be more predominant in asian type 2 diabetes mellitus patients. CONCLUSION: This study found that adding extra virgin olive oil on top of meals provided no additional benefit in terms of post-prandial glucose excursion.
Diet, Diabetic

Elderly are often associated with multiple social and health problems. Family members are important in helping them doing their daily activities. For elderly diabetics, family support has a role in diabetes management and glucose control. The aim of this study is to explore the perceptions of elderly diabetics regarding the role of family support on their glucose control. This qualitative technique was a part of the study on glucose control and its associated factors among elderly diabetics. It was conducted from February until May 2009 in Kulim. Ten respondents were purposively sampled based on their glucose control. HbA1c 6.5% or less was considered as good glucose control. In depth interview, using semi-structured interview guide was used in this study. The conversation had been taped, transcribed to verbatim and analyzed manually using thematic analysis. All ten respondents perceived that family support did not play a role on their glucose control. They believed that self-awareness and self-determination were important to control the glucose level. Those with good glucose control practiced healthy diet, and not affected by food prepared by their family members compared to those with poor glucose control. However, both groups claimed that, they did not receive much advice from their family members and no special food was prepared for them. Elderly diabetics should be motivated on self-determination and focusing on good glucose control. Health education should be given to patients and their family members to increase their diabetes knowledge especially on useful advice and proper food preparation. It could motivate the elderly diabetics to control their glucose level.
Diabetes Mellitus ; Diabetic Diet ; Aged ; Family ; Motivation

BACKGROUND: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.
Compliance ; Comprehension ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet Records ; Energy Intake ; Humans ; Meals ; Patient Compliance

The purpose of this study was to evaluate importance and performance of dietitian's task at long term care hospitals foodservices in the Busan.Kyongnam area. The research was performed through using questionnaires and conducted from June 11 to July 16, 2010 for 186 dietitians at 141 long-term care hospitals. Seventy-two percent of hospitals had two dietitians and 69% of them had a dietitian's office. Fifty-two percent of dietitians has worked for less than 2 years at long term care hospital, and 37.1% of them worked additional tasks. Seventy-three percent of hospitals conducted a therapeutic diet program and the therapeutic diets frequently provided were diabetic diet > tube feeding diet > dysphasia diet > sodium controlled diet. Mean score for the importance (4.36/5.00) and performance (3.91/5.00) of dietitian's tasks were significantly different (p < 0.001). The importance and performance grid showed that the purchase-inspection management and sanitation-safety management were high scores to the importance and performance (doing great area), menu-foodservice management and cooking-working management were low scores to the importance and high scores to the importance (overdone area), and nutrition management was low scores to the importance and performance (low priority). Forty-three percent of dietitians agreed with the needs for role separation between foodservice dietitian and clinical dietitian.
Aphasia ; Diet, Diabetic ; Diet ; Enteral Nutrition ; Long-Term Care ; Surveys and Questionnaires ; Sodium

Comprehensive education is the cornerstone of diabetes management. However, in Korea, diabetes education is constrained by short office visits. This article intends to introduce various educational strategies, particularly regarding diet style modification, that can be employed in the time-limited outpatient setting to improve diabetes management. Instructing patients to reduce their intake of carbohydrates, the predominant nutrient consumed in a traditional Korean diet, may be beneficial. The use of novel educational technologies or the introduction of new healthy diet plans may also help.
Carbohydrates ; Diabetes Mellitus ; Diet* ; Diet, Diabetic ; Education* ; Educational Technology ; Humans ; Korea ; Nutrition Therapy ; Office Visits ; Outpatients

BACKGROUND: Koreans eat rice, which is usually served in a rice bowl. We investigated the effect of a meal plan using small rice bowls on the total energy intake (TEI) and the marcronutrient intake in Korean men with type 2 diabetes. METHODS: A total of 62 men with type 2 diabetes were divided by body mass index (BMI) (normal weight [NW], BMI<23 kg/m2; overweight [OW], 23< or =BMI<25 kg/m2; obese [OB], BMI> or =25 kg/m2) and proportions of carbohydrate intake to TEI (PCI) (low carbohydrate intake [LC], <55%; recommended carbohydrate intake [RC], > or =55% and < or =60%; high carbohydrate intake [HC], >60%). The 3-day dietary records were analyzed for TEI and proportions of macronutrients, before and 2 weeks after a small-sized (300 mL) rice bowl based education was given. RESULTS: There were no significant differences in the age and BMI within the sub-groups by BMI and PCI groups. In baseline, the ratio of TEI to recommended total energy intake (RTR) of OW and OB were higher than that of NW. The PCI of HC was higher than that of LC and alcohol intake of HC was lower than that of LC. After education, the reduction of RTREI in OB was higher than that in OW and NW. The reduction of PCI in HC was higher than that of LC. CONCLUSION: A small rice bowl based meal plan was effective for the reduction of energy intake and control of marcronutrient intake in Korean obese men with type 2 diabetes consuming a high carbohydrate diet.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Diet Records ; Energy Intake ; Humans ; Male ; Meals ; Overweight ; Pilot Projects

BACKGROUND: The frequency of lower extremity amputation due to diabetic foot has been increasing in type 2 diabetic patients. The aim of this study was to observe the incidence, clinical aspects and associated risk factors for diabetic foot. METHODS: We evaluated the incidence of diabetic foot through a five-year observation of type 2 diabetic patients who presented to St. vincent's Hospital between January and December 2003. To identify the risk factors for diabetic foot, we evaluated mean glycosylated hemoglobin A1c (HbA1c) every six months and assessed renal function based on the existence of proteinuria and estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) equation. Patients were also evaluated for retinopathy, peripheral neuropathy and autonomic neuropathy using Ewing's method. RESULTS: From an initial pool of 613 patients, the observational study of 508 patients (82.9%) was completed. The mean age, duration of diabetes and HbA1c were 50.3 +/- 10.6 yrs, 7.2 +/- 6.5 yrs and 8.8 +/- 2.1%, respectively. Diabetic foot occurred in 32 patients (6.3%). The incidence of diabetic foot increased when diabetic retinopathy (OR = 6.707, 2.314~19.439), peripheral neuropathy (OR = 2.949, 1.075~8.090), and autonomic neuropathy (OR = 3.967, 1.476~10.660) were present and when the MDRD GFR (OR = 5.089, 1.712~15.130) decreased. Mean HbA1c (OR = 12.013, 1.470~98.179) was found to be an independent risk factor for diabetic foot. CONCLUSION: The present study confirmed the importance of intensive glycemic control and the role of autonomic dysfunction in the development of diabetic foot. In addition, diabetic retinopathy and impaired renal function proved to be factors associated with the occurrence of diabetic foot. Therefore, intensive glycemic control, as well as periodic examination of renal function, are essential for the prevention of diabetic foot.
Amputation ; Diabetic Foot ; Diabetic Neuropathies ; Diabetic Retinopathy ; Diet ; Glomerular Filtration Rate ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Lower Extremity ; Peripheral Nervous System Diseases ; Proteinuria ; Risk Factors

It is generally accepted that diet modification provides beneficial effects on the management of diabetes. In the present study, we evaluated the effects of diet modification on nutrient intake and quality of life in a large sample of diabetic patients. This study was conducted using data from the Korea National Health and Nutrition Examination Survey IV and V (2007-2010). A total of 2,484 of diabetic patients were included in the analysis. Then, we compared the overall quality of dietary intake between diabetic patients with diet modification and those without dietary modification. The result showed that subjects on diabetic diet (DDG) showed lower levels of total cholesterol, triglyceride, and AST before and after the adjustment for covariates (all p < 0.05). The results of nutrient assessment showed that DDG had lower intakes of total energy, fat, and carbohydrate (all p < 0.05), but higher intakes of energy from protein, vitamin B1, vitamin B2, niacin and vitamin C than NDG. (all p < 0.05). In addition, nutritional adequacy ratio of calcium and vitamin B2 were significantly higher in DDG than those in normal diet group (NDG) (p < 0.05). However, we observed no significant differences in quality of life between two groups. In conclusion, diet modification in diabetic patients seemed to be effective to improve blood lipid profile and the adequacy of nutrient intake without sacrificing the quality of life.
Ascorbic Acid ; Calcium ; Cholesterol ; Diet, Diabetic ; Diet ; Food Habits* ; Humans ; Korea ; Meals* ; Niacin ; Nutrition Surveys* ; Quality of Life* ; Riboflavin ; Thiamine ; Triglycerides

BACKGROUND: The results of previous studies suggest that portion size is a major factor dictating dietary energy intake. We investigated the relationship between frequencies of rice meals, bowl volumes, and dietary energy intake in a sample of patients with type 2 diabetes. METHODS: A total of 203 type 2 diabetes patients were enrolled in the study. A one-week food diary was collected from each patient and used to assess the types of meal consumed as well as the context of consumption. The volumes of the eating vessels (rice, soup and side dish bowls) used by each patient were obtained by comparisons to measuring cylinders, and dietary energy and macronutrient intake were estimated for each patient by consulting three-day dietary records. RESULTS: The mean age of the 203 subjects (male: 76, female: 127) was 53.9 +/- 9.1 years and the average body mass index (BMI) was 25.6 +/- 4.2 kg/m2. Among the subjects who ate three times per day, 96.4% consumed rice more than twice out of three meals. The median volume of rice bowls used by patients was 350 cc, of soup bowls was 530 cc and of side dish bowls was 260 cc. Portion size, as estimated by rice bowl volume, was not associated with BMI. Male subjects tended to eat out of larger rice and soup bowls (P < 0.001). Portion size was correlated with energy intake from rice (P = 0.021), but not with total energy intake (kcal/kg/day), especially in male subjects. CONCLUSION: Portion size of rice bowl was correlated with energy intake from rice, but not with total energy intake in male subjects with type 2 diabetes. To design effective meal planning methods for patients with type 2 diabetes, further prospective studies are warranted to investigate causative relationships between portion size andmetabolic conditions as well as variation by gender.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet Records ; Eating ; Energy Intake ; Humans ; Male ; Meals

BACKGROUND: The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels. METHODS: Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records. RESULTS: Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups. CONCLUSION: The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.
Blood Glucose ; Body Weight ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet ; Energy Intake ; Female ; Humans ; Meals ; Obesity ; Weight Loss