The relationship between eating patterns and metabolic control in patients with non-insulin-dependent diabetes...

The most important element in the therapeutic plan of patients with non-insulin-dependent diabetes mellitus (NIDDM) is dietary modification. Dietary instructions target patient behaviors in two areas: following an exchange-based diet and adhering to the same basic eating pattern every day. However, there is little empirical data that addresses the relationship between dietary instruction and metabolic control. Fifty patients with NIDDM were enrolled in an 8-week study to ascertain if either dietary approach was more predictive of improved metabolic control. The effect on metabolic control was determined by changes in HbA1c over a 2- to 3-month period. Patients added or deleted almost half of all prescribed exchanges, and added or deleted an average of one prescribed meal or snack per day. Deviations in prescribed eating patterns, particularly breakfast-skipping and snack additions and deletions, were related to poorer metabolic control. Maintaining consistent eating patterns should be further evaluated as an important component of dietary instruction for patients with NIDDM.