Diet, exercise intervention increased satisfaction in newly diagnosed type 2 diabetes

EASD 47th Annual Meeting

LISBON — Introducing diet and exercise programs to patients who are newly diagnosed type 2 diabetes may improve patient satisfaction with treatment and health status, data from a recent randomized trial suggest.

Previous data from the Early Activity in Diabetes (ACTID) trial, which studied the effects of motivational interviewing, demonstrated that over 12 months interventions to improve diet alone, as well as diet and exercise, improved glycemic control and weight loss while reducing medication use, as compared with usual care. During the study period, advice on diet was as effective as diet plus exercise. Based on these findings, and due to a lack of data on the effect of diet and exercise on psychological outcomes, researchers from the United Kingdom conducted a randomized trial to assess these effects compared with intense dietary intervention or usual care in newly diagnosed patients.

The study included patients aged 50 to 70 years who were diagnosed with diabetes within 197 days. Participants were randomly assigned in a 2:5:5 fashion to usual care (initial dietary consultation with 6-month follow-up; n=99), dietary intervention (3 dietary consults monthly with nurse support; n=248) or dietary plus physical activity intervention (same as dietary intervention plus a pedometer-based exercise regimen; n=246). Questionnaires on patient satisfaction were completed at baseline, 6 and 12 months.

The researchers found no statistically significant differences in illness perception, treatment satisfaction or EQ-5D at baseline. However, patients in the usual care arm had a lower Diener Satisfaction with Life Scale score compared with the dietary (22 vs. 24; P=.001) and dietary plus activity arms (22 vs. 24; P=.006) at baseline. There was no difference between the dietary and dietary plus activity arms.

During the study period, the usual care arm was only associated with improvements in understanding (6.7 vs. 7.4; P=.012), expectation of disease continuation (9.0 vs. 9.5; P=.028) and concern of their illness (5.3 vs. 4.7; P=.018), according to the researchers.

Among patients in the dietary alone arm, understanding increased (6.9 vs. 8.0; P<.001), concern waned (5.7 vs. 5.1; P=.005) and a feeling of having control of their illness was gained (7.1 vs. 7.6; P=.002). In addition, improvements were observed in treatment satisfaction (29 vs. 32; P<.001) and self-reported health scores (73 vs. 76; P=.007). Though health scores did not improve among the dietary and activity arm (74 vs. 76; P=.115), improvements similar to those in the dietary alone arm were observed. Life satisfaction scores did not improve among either group.

Compared with patients in the usual care arm, those in the dietary alone and dietary plus activity arms felt they were in greater control of their disease (P=.002 and P<.001), were more satisfied with treatment (P=.002 and P<.001) and had higher self-reported health scores (P=.047 and P=.013), the researchers wrote.

For more information:

Bennett-Britton I. Abstract #211. Presented at: The European Association for the Study of Diabetes 47th Annual Meeting; Sept. 12-16, 2011; Lisbon.

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