Nutrition Education Improves Metabolic Outcomes among Older Adults with Diabetes Mellitus: Results from a Randomized Controlled Trial
Abstract
Background Few diabetes education programs have been designed specifically for older adults. This study evaluated the impact of a nutrition intervention on the blood glucose and lipoprotein levels of adults > or =65 years of age without functional limitations but with type 2 diabetes for > or =1 year.Methods Ninety-eight people were randomized to the experimental or control group. A pretest-posttest control group design was used to evaluate the intervention. Ninety-two people (94%) completed the study. The 10-week intervention incorporated principles from information processing, learning theory, and Social Cognitive Theory to meet the needs of older adults. Analysis of covariance compared outcomes between groups. The paired t test compared results within groups.Results Participants exceeded the guidelines for optimal glycemic control at pretest. The experimental group had greater improvements in fasting plasma glucose (P = 0.05) and glycated hemoglobin (P < 0.01) than the control group. Significantly more participants in the experimental group than control group met the treatment goals for total cholesterol at posttest (P < 0.05).Conclusions Older adults with diabetes need additional education to achieve metabolic control. Nutrition education can improve metabolic control among this cohort. Improved metabolic outcomes reduce the morbidity and mortality associated with diabetes.
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MNT has proven to be beneficial in older adults with diabetes.
“MNT has proven to be beneficial in older adults with diabetes84.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [84]
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423 · see citing works
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667 · see citing works
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059 · see citing works
The Continuing Epidemics of Obesity and Diabetes in the United States
Mokdad, A. H. (2001) · JAMA · doi:10.1001/jama.286.10.1195 · Cited by 2,730 · see citing works
Novak, J. D. (1998) · Choice Reviews Online · doi:10.5860/choice.36-1103 · Cited by 1,651 · see citing works
A Guttman Health Scale for the Aged
Rosow, I., & Breslau, N. (1966) · Journal of Gerontology · doi:10.1093/geronj/21.4.556 · Cited by 1,132 · see citing works
Hyperglycemie and Microvascular and Macrovascular Disease in Diabetes
Klein, R. (1995) · Diabetes Care · doi:10.2337/diacare.18.2.258 · Cited by 849 · see citing works
Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients.
Shichiri, M., Kishikawa, H., Ohkubo, Y., & Wake, N. (2000) · PubMed · Cited by 727 · see citing works
Racial and ethnic differences in glycemic control of adults with type 2 diabetes.
Harris, M. I., Eastman, R. C., Cowie, C. C., Flegal, K. M., & Eberhardt, M. S. (1999) · Diabetes Care · doi:10.2337/diacare.22.3.403 · Cited by 643 · see citing works
NIDDM and Its Metabolic Control Predict Coronary Heart Disease in Elderly Subjects
Kuusisto, J., Mykkänen, L. M., Pyörälà, K., & Laakso, M. (1994) · Diabetes · doi:10.2337/diab.43.8.960 · Cited by 588 · see citing works
Spector, W. D., Katz, S., MURPHY, J. B., & Fulton, J. P. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90004-x · Cited by 565 · see citing works
Fillenbaum, G. G. (1985) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1985.tb01779.x · Cited by 511 · see citing works
Wing, R. R., Goldstein, M. G., Acton, K. J., Birch, L. L., Jakicic, J. M., Sallis, J. F., West, D. S., Jeffery, R. W., & Surwit, R. S. (2001) · Diabetes Care · doi:10.2337/diacare.24.1.117 · Cited by 445 · see citing works
Diabetes in America: Epidemiology and Scope of the Problem
Harris, M. I. (1998) · Diabetes Care · doi:10.2337/diacare.21.3.c11 · Cited by 441 · see citing works
Some Internal Psychological Factors Influencing Consumer Choice
McGuire, W. J. (1976) · Journal of Consumer Research · doi:10.1086/208643 · Cited by 393 · see citing works
Lehto, S., Rönnemaa, T., Haffher, S. M., Pyörälà, K., Kallio, V., & Laakso, M. (1997) · Diabetes · doi:10.2337/diab.46.8.1354 · Cited by 374 · see citing works
Studies of educational interventions and outcomes in diabetic adults: A meta-analysis revisited
Brown, S. A. (1990) · Patient Education and Counseling · doi:10.1016/0738-3991(90)90070-2 · Cited by 361 · see citing works
Padgett, D. K., Mumford, E., Hynes, M. M., & Carter, R. (1988) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(88)90040-6 · Cited by 322 · see citing works
Use Of Food Nutrition Labels is Associated with Lower Fat Intake
NEUHOUSER, M. L., KRISTAL, A. R., & PATTERSON, R. E. (1999) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(99)00013-9 · Cited by 308 · see citing works
Stearne, M. R., Palmer, S. L., Hammersley, M. S., Franklin, S. L., Spivey, R. S., Lévy, J., Tidy, C. R., Bell, N. J., Steemson, J., Barrow, B. A., et al. (1998) · Cited by 302 · see citing works
UK Prospective Diabetes Study Group (1998) · BMJ · doi:10.1136/bmj.317.7160.720 · Cited by 301 · see citing works
FRANZ, M. J., MONK, A., BARRY, B., McCLAIN, K., WEAVER, T., COOPER, N., UPHAM, P., BERGENSTAL, R., & MAZZE, R. S. (1995) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(95)00276-6 · Cited by 289 · see citing works
Improving self-care among older patients with type II diabetes: The “sixty something…” Study
Glasgow, R. E., Toobert, D. J., Hampson, S. E., Brown, J., Lewinsohn, P. M., & Donnelly, J. (1992) · Patient Education and Counseling · doi:10.1016/0738-3991(92)90102-o · Cited by 219 · see citing works
Do Nutrition Label Readers Eat Healthier Diets? Behavioral Correlates of Adults’ Use of Food Labels
Kreuter, M. W., Brennan, L. K., Scharff, D. P., & Lukwago, S. N. (1997) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(18)30175-2 · Cited by 200 · see citing works
Brown, S. A. (1992) · Research in Nursing & Health · doi:10.1002/nur.4770150603 · Cited by 178 · see citing works
Diabetes Support Groups Improve Health Care of Older Diabetic Patients
Gilden, J. L., HENDRYX, M. S., Clar, S., Casia, C., & Singh, S. P. (1992) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1992.tb01935.x · Cited by 165 · see citing works
Kris-Etherton, P., & Dietschy, J. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.5.1590s · Cited by 158 · see citing works
Frequency and Determinants of Diabetes Patient Education Among Adults in the U.S.Population
Coonrod, B. A., Betschart, J. E., & Harris, M. I. (1994) · Diabetes Care · doi:10.2337/diacare.17.8.852 · Cited by 157 · see citing works
Direct Medical Costs of Complications Resulting From Type 2 Diabetes in Hie U.S.
O’Brien, J. A., Shomphe, L. A., Kavanagh, P. L., Raggio, G., & Jaime, J. (1998) · Diabetes Care · doi:10.2337/diacare.21.7.1122 · Cited by 151 · see citing works
The Effects of Treatment on the Direct Costs of Diabetes
Herman, W. H., & Eastman, R. C. (1998) · Diabetes Care · doi:10.2337/diacare.21.3.c19 · Cited by 143 · see citing works
Krop, J. S., Powe, N. R., Weller, W. E., Shaffer, T., Saudek, C. D., & Anderson, G. F. (1998) · Diabetes Care · doi:10.2337/diacare.21.5.747 · Cited by 71 · see citing works
Laakso, M., & Kuusisto, J. (1996) · Annals of Medicine · doi:10.3109/07853899608999101 · Cited by 58 · see citing works
Clinical Criteria that Reflect C-Peptide Status in Idiopathic Diabetes
Welborn, T. A., Garcia‐Webb, P., Bonser, A. M., McCann, V. J., & Constable, I. J. (1983) · Diabetes Care · doi:10.2337/diacare.6.3.315 · Cited by 57 · see citing works
Nutrition Education and Social Learning Interventions for Type II Diabetes
Glasgow, R. E., Toobert, D. J., Mitchell, D. L., Donnelly, J., & Calder, D. (1989) · Diabetes Care · doi:10.2337/diacare.12.2.150 · Cited by 53 · see citing works
Evaluation of a Food Label Nutrition Intervention for Women with Type 2 Diabetes Mellitus
Miller, C. K., Jensen, G. L., & Achterberg, C. (1999) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(99)00082-6 · Cited by 37 · see citing works
Self-citationMiller, C. K., Probart, C., & Achterberg, C. (1997) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572179702300407 · Cited by 33 · see citing works
Self-citationMiller, C. K., & Brown, J. B. (1999) · PubMed · Cited by 20 · see citing works
Self-citationWheeler, M. L., Franz, M. J., Heins, J. M., et al. (1994) · Diabetes Care · doi:10.2337/diacare.17.5.480 · Cited by 11 · see citing works
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Cited by
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Nutrition therapy recommendations for the management of adults with diabetes
Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J., Neumiller, J. J., Nwankwo, R., Verdi, C. L., Urbanski, P., et al. (2013) · Diabetes Care · doi:10.2337/dc13-2042 · Cited by 1,129 · see citing works
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.003 · Cited by 914 · see citing works
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Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J., Neumiller, J. J., Nwankwo, R., Verdi, C. L., Urbanski, P., et al. (2014) · Diabetes Care · doi:10.2337/dc14-s120 · Cited by 766 · see citing works
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Marín-Peñalver, J. J., Martín-Timón, I., Sevillano-Collantes, C., & Cañizo-Gómez, F. J. D. (2016) · World Journal of Diabetes · doi:10.4239/wjd.v7.i17.354 · Cited by 647 · see citing works
Guidelines for improving the care of the older person with diabetes mellitus
California Healthcare Foundation/American Geriatrics Society, C. (2003) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.51.5s.1.x · Cited by 651 · see citing works
Diabetes in Older Adults: A Consensus Report
Sue Kirkman, M., Briscoe, V. J., Clark, N., Florez, H., Haas, L. B., Halter, J. B., Huang, E. S., Korytkowski, M. T., Munshi, M. N., Odegard, P. S., et al. (2012) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12035 · Cited by 548 · see citing works
Barnard, N. D., Cohen, J., Jenkins, D. J., Turner-McGrievy, G., Gloede, L., Green, A., & Ferdowsian, H. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.26736h · Cited by 449 · see citing works
Sinclair, A. J., Paolisso, G., Castro, M., Bourdel-Marchasson, I., Gadsby, R., & Rodriguez Mañas, L. (2011) · Diabetes & Metabolism · doi:10.1016/s1262-3636(11)70962-4 · Cited by 298 · see citing works
Nutrition Recommendations and Interventions for Diabetes–2006
American Diabetes Association (2006) · Diabetes Care · doi:10.2337/dc06-9914 · Cited by 205 · see citing works
Vegetarian and vegan diets in type 2 diabetes management
Barnard, N. D., Katcher, H. I., Jenkins, D. J., Cohen, J., & Turner-McGrievy, G. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.2009.00198.x · Cited by 164 · see citing works
Barnard, N. D., Gloede, L., Cohen, J., Jenkins, D. J. A., Turner-McGrievy, G., Green, A. A., & Ferdowsian, H. (2009) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2008.10.049 · Cited by 154 · see citing works
Evidence-based practice guideline for the treatment for diabetes in Japan 2013
Tajima, N., Noda, M., Origasa, H., Noto, H., Yabe, D., Fujita, Y., Goto, A., Fujimoto, K., Sakamoto, M., & Haneda, M. (2015) · Diabetology International · doi:10.1007/s13340-015-0206-2 · Cited by 154 · see citing works
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Grant, L. P., Haughton, B., & Sachan, D. S. (2004) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2004.01.008 · Cited by 70 · see citing works
Diabetes Self-Management Education for Older Adults: General Principles and Practical Application
Suhl, E., & Bonsignore, P. (2006) · Diabetes Spectrum · doi:10.2337/diaspect.19.4.234 · Cited by 69 · see citing works
Fitzpatrick, S. E., Reddy, S., Lommel, T. S., Fischer, J. G., Speer, E. M., Stephens, H., Park, S., & Johnson, M. A. (2008) · Journal of Nutrition For the Elderly · doi:10.1080/01639360802060223 · Cited by 64 · see citing works
Smalls, B. L., Ritchwood, T. D., Bishu, K. G., & Egede, L. E. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17030950 · Cited by 54 · see citing works
- Authors
- Miller, C. K., Edwards, L., Kissling, G., & Sanville, L.
- Affiliations
- University of North Carolina at Greensboro (US)
- Corresponding author
- Miller, Carla K
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2002-02
- Volume
- 34
- Issue
- 2
- Pages
- 252-259
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W1979270351
- Cited by
- 194
- References
- 40
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 9 · 2020: 7 · 2019: 6 · 2018: 13 · 2017: 9 · 2016: 15 · 2015: 13 · 2014: 12 · 2013: 10 · 2012: 7
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r15dk055989-01)
- National Institute of Diabetes and Digestive and Kidney Diseases (R15 DK 55989)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- nutrition education, type 2 diabetes, older adults, glycemic control, fasting blood glucose, HbA1c, lipoproteins, total cholesterol, diabetes education, social cognitive theory, learning theory, information processing
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Lipoproteins, Male, Middle Aged, Patient Education as Topic, Self Care, United States, Nutritional Sciences
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