| Abstract | Svrha rada bila je: (i) odrediti utjecaj nutritivne intervencije u osoba oboljelih od šećerne bolesti tipa 2 na regulaciju glikemije (glukoza u plazmi, glikirani hemoglobin HbA1c), lipidnoga profila (ukupnog kolesterola, LDL-kolesterola, HDL-kolesterola i triglicerida) i antropometrijske parametre (tjelesnu masu i indeks tjelesne mase- ITM), (ii) odrediti odnos između prehrambenih navika i znanja o prehrani u šećernoj bolesti tipa 2 te njihov utjecaj na regulaciju glikemije i lipidnoga profila kroz dvanaest mjeseci, (iii) analizirati jelovnike i odrediti adekvatnu bazu podataka za planiranje prehrane u šećernoj bolesti, (iiii) validirati upitnik znanja o prehrani. U istraživanje je bilo uključeno 160 bolesnika s nereguliranom šećernom bolešću tipa 2 (HbA1c > 7,5 %) prosječne dobi 61,8 ± 8,5 godina; ITM 32,57 ± 6,48 kg/m² te duljine trajanja bolesti 10,9 ± 7,6 godina. Bolesnici su sudjelovali u petodnevnom programu dijabetološke dnevne bolnice u kojoj su prolazili intenzivnu nutritivnu intervenciju i edukaciju te su praćeni kroz kontrolne preglede nakon 3, 6 i 12 mjeseci. Validiranim upitnikom provjeravalo se znanje o prehrani u šećernoj bolesti, a prehrambene navike praćene su kroz odabir jelovnika mediteranske, dijabetične ili dijete s većim udjelom ugljikohidrata. Rezultati istraživanja pokazali su kako primjena nutritivne intervencije statistički značajno utječe na smanjenje koncentracije HbA1c (p < 0,001); glukoze u plazmi (p = 0,003); LDL kolesterola (p = 0,022); triglicerida (p = 0,019) i ukupnog kolesterola (p = 0,021) tijekom promatranog razdoblja. Na kraju istraživanja došlo je do statistički značajnog povećanja udjela bolesnika (10,3 vs. 23,1 %; p < 0,05) s normalnom tjelesnom masom (ITM < 25 kg/m²) te smanjenja udjela (64,5 vs 53,8 %; p < 0,05) pretilih bolesnika (I, II i III stupanj) u ispitivanom uzorku. Ustanovljeno je kako prehrambene navike i odabir jelovnika koreliraju s biokemijskim parametrima. Bolesnici koji su tijekom edukacije najviše birali mediteransku dijetu, na početku, tijekom perioda praćenja te na kraju studije imali su najmanje vrijednosti svih biokemijskih parametara u odnosu na ostale bolesnike (p < 0,05). Dokazan je statistički značajan (p < 0,05) utjecaj nutritivne intervencije na promjenu znanja o prehrani u šećernoj bolesti te utjecaj istih na sniženje vrijednosti koncentracije HbA1c i lipidnog profila. Provedeno istraživanje ustanovilo je da primjena nutritivne intervencije koja uključuje edukaciju o pravilnoj prehrani, provjeru znanja o prehrani i prehrambenih navika rezultira boljom regulacijom šećerne bolesti, utvrđenom smanjenjem vrijednosti koncentracije HbA1c te ima povoljni učinak na smanjenje tjelesne mase i poboljšanje lipidnoga profila u oboljelih od šećerne bolesti tipa 2. Dobiveni rezultati povećavaju razumijevanje kako se stjecajem znanja o prehrani omogućuje bolja kontrola šećerne bolesti tipa 2. |
| Abstract (english) | The purpose of this work was to: (i) determine the impact of nutritional intervention in persons with type 2 diabetes on the regulation of glycaemia (plasma glucose, glycated hemoglobin HbA1c), lipid profile (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) and anthropometric parameters (weight and body mass index - BMI) (ii) determine the relationship between dietary habits and knowledge about nutrition in type 2 diabetes and their influence on the regulation of glycemia and lipid profile during the twelve months follow-up, (iii), analyse hospital menus and determine adequate food composition database for diet planning in diabetes, (iiii) validation of a nutrition knowledge questionnaire for patients with diabetes. The study included 160 patients with non-regulated type 2 diabetes (HbA1c > 7.5 %), median age 61.8 ± 8.5 years, BMI 32.57 ± 6.48 kg/m² and disease duration 10.9 ± 7.6 years. All subjects have participated in an intensive 5-day program in daily hospital, involving education and nutritional intervention, followed by three follow-up visits after 3, 6, and 12 months. A validated questionnaire was used to determine knowledge about nutrition in diabetes and dietary habits were monitored through patient’s selection of menus from diabetic, Mediterranean or higher-carbohydrate diets. The study showed that nutritional intervention had a statistically significant effect on lowering concentrations of HbA1c (p <0.001); plasma glucose (p = 0.003); LDL cholesterol (p = 0.022); triglycerides (p = 0.019) and total cholesterol (p = 0.021) during the observed period. At the end of the study, there was a statistically significant increase the number of patients (10.3 vs. 23.1 %; p <0.05) with normal weight (BMI < 25 kg/m²) and a decrease in the number (64.5 vs 53, 8 %, p < 0.05) of obese patients (obese class I, II, III) in the examined sample. It was found that dietary habits correlate with the biochemical parameters of the patients at the beginning, during the follow-up period and at the end of the study. In patients who chose menus of the Mediterranean diet the most during the five-day education, after three, six and twelve months they had the lowest values of all biochemical parameters compared to other patients (p < 0.05). There was a statistically significant (p < 0.05) influence of nutritional intervention on changing dietary habits and knowledge about nutrition in patients with type 2 diabetes, and the influence on the decreasing levels of HbA1c and lipid profile. The study found that nutritional intervention, which includes education, testing of knowledge about nutrition and eating habits, results better regulation of diabetes, established reduction of HbA1c and has a beneficial effect on weight loss and lipid profile in patients with diabetes type 2. The obtained results increase the understanding how education and knowledge about nutrition enable better control of diabetes type 2. |
