The role and place of adequate nutrition in optimizing management of diabetes mellitus type 2

Abstract

Inadequate nutrition prevents patients with type 2 diabetes (T2DM) from achieving target values of glycemic and non-glycemic parameters. Aim: to evaluate metabolic effects of the balanced diet including specialized nutrition (SN). Material and methods: the randomized clinical trial included 60 patients with type 2 diabetes treated with a double combination metformin + glibenclamide, who were divided into 2 groups. Patients in the treatment group received SN Glucerna SR which replaced the main meal; the comparison group of patients were on a natural low-calorie diet. Changes in glycemic and non-glycemic parameters were evaluated in 12 weeks. Results: SN improves glycemic control without correction of the background antidiabetic therapy. Thus, the treatment group demonstrated a decrease in HbA1c from 7.8 ± 1.6 to 6.7 ± 1.1%, fasting glycemia - from 7.5 ± 1.2 to 5.9 ± 0.6 mmol/l, postprandial glucose (PPG) - from 10.6 ± 1.0 to 7.5 ± 0.5 mmol /l, glycemic variability SD - from 2.0 ± 0.8 to 1.1 ± 0.6 mmol/l, and normalization of glycemic pattern (p < 0.05). SN contributed to improvement of the lipid profile (p < 0.05). Conclusions: SN in patients with type 2 diabetes and visceral obesity is associated with positive dynamics of metabolic parameters. Elimination of postprandial hyperglycemia induces a decrease in glycemic variability, minimizing the progression of type 2 diabetes.