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Dietetic and educational interventions improve clinical outcomes of diabetic and obese clients with mental impairment
Author(s) -
Hunt Kerri,
Stiller Kathy
Publication year - 2017
Publication title -
nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.479
H-Index - 31
eISSN - 1747-0080
pISSN - 1446-6368
DOI - 10.1111/1747-0080.12340
Subject(s) - medicine , psychological intervention , body mass index , obesity , diabetes mellitus , schizophrenia (object oriented programming) , type 2 diabetes , intervention (counseling) , medical record , audit , physical therapy , psychiatry , endocrinology , management , economics
Aim The aim of this study was to evaluate the effect of dietetic and educational interventions provided to clients with type 2 diabetes (with or without obesity) or obesity‐only residing in supported residential facilities and characterised by mental impairment. Methods A retrospective audit involving the retrieval of information from medical records and databases was undertaken to evaluate the effect of dietetic and educational interventions. Clinical outcomes were weight, body mass index and glycosylated haemoglobin ( HbA1c ) levels. Results A total of 91 clients were included, 47 with type 2 diabetes (with or without obesity) and 44 with obesity‐only. All but one had schizophrenia, an intellectual disability or another psychological condition. After interventions, the diabetic subgroup demonstrated significant decreases in weight (mean [ SD ] initial = 101.5 [20.7], final = 97.8 [20.6] kg, P = 0.001) and body mass index (mean [ SD ] initial = 35.8 [8.1], final = 34.4 [7.8] kg/m 2 , P = 0.001) and a non‐significant decrease in HbA1c over time. The obesity‐only subgroup showed no significant change in outcomes. Factors significantly negatively impacting at least one outcome included the presence of schizophrenia ( P ≤ 0.017) and refusal of intervention(s) ( P ≤ 0.048), whereas a significant positive impact was seen for a greater total number of visits to a dietitian or diabetes educator ( P ≤ 0.024). Conclusions These results provide evidence to support the effectiveness of dietetic and educational interventions for this vulnerable client group.