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Medical nutrition therapy appears to benefit patients with prediabetes
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NASHVILLE, Tenn. — Compared with a usual care program, patients with prediabetes and overweight or obesity experienced significantly decreased HbA1c levels and diabetes risk score through medical nutrition therapy.
“We know that statistic-wise, 86 million Americans aged 20 years or older had prediabetes from 2009 to 2012,” Anna Parker, DCN, MS, RD, CDE, of Anaheim Clinical Trials, told Endocrine Today. “This population is at increased risk for developing type 2 diabetes and cardiovascular disease. At this time, CMS does not cover reimbursement to see a registered dietitian nutritionist in patients with prediabetes, it’s only covered in patients who have diabetes.”
Anna Parker
Parker and colleagues evaluated 76 adults with overweight or obesity and impaired fasting plasma glucose or an HbA1c of 5.7% to 6.4% to determine the effect of medical nutrition therapy (MNT) compared with usual care on FPG, HbA1c, serum lipid levels and diabetes risk score at the end of the 12-week intervention. Participants were randomly assigned to MNT or usual care.
“Basically, the [usual care group] was told to exercise more and follow a diet, but they did not have individualized intervention, while the medical nutrition group met with a dietitian four times during the 12 weeks,” Parker said.
The researchers used repeated measures of analysis of variance to understand between-group differences and two measures of time (baseline and 12 weeks after intervention).
After the 12-week intervention, the MNT groups had significantly lower levels of HbA1c (5.79%) compared with an increase in the usual care group (6.01%; P = .01).
According to Parker, participants completed a questionnaire at the first visit and after 12 weeks to evaluate diabetes risk score.
The diabetes risk score decreased more among the MNT group compared with the usual care group (P = .001). Parker said this might be attributed to the MNT group eating more vegetables and participating in more physical activity compared with the usual care group.
A reduction in total cholesterol (P = .01) and LDL cholesterol (P = .04) was seen among both groups.
“We are stating that CMS should cover reimbursement for patients with prediabetes so they can see a dietitian, and that we stop this from transitioning to diabetes,” Parker said. – by Amber Cox
Reference:
Parker A, et al. Abstract #1209. Presented at: Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2015; Nashville, Tenn.
Disclosure: The researchers report no relevant financial disclosures.