Effect of Nutritional Counselling on Risk Level of Glycosylated Hemoglobin (HbA1c) of Middle-aged Non-insulin Dependent Diabetics

Abstract

Glycosylated hemoglobin (HbA_1c) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over a prolonged period of time. As the average amount of plasma glucose increases, the fraction of glycosylated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous months prior to the measurement. Present study was conducted on diabetic patients who were suffering from type II diabetes mellitus and were only on oral hypoglycemic drugs for the treatment of the disease. Diabetics registered at the Govt. Sardar Patel Medical College and Hospital, Bikaner, Rajasthan, India as outdoor patients were studied to find out the effect of nutritional counselling on HbA_1c level in blood. The study was conducted on 180 middle-aged diabetics from middle income group. The total sample was divided into two strata. Stratum I included diabetics suffering from last 5 years and stratum II included diabetics suffering from last 10 years. Further in each strata diabetics were divided on the basis of sex and BMI into three categories i.e., obese, normal weight and underweight. A structured interview schedule was developed to collect the pertinent information from the respondents. Individual counselling method was opted to educate the diabetics about life style modifications to control the disease. Data on HbA_1c level was collected twice—first record was taken at the starting of the study (prior to counselling) and the second after 3 months of nutritional counselling. Obese subjects were having ‘seriously elevated’ levels (8.1–10%) of HbA_1C, whereas normal weight and underweight subjects were noted for ‘elevated’ levels (7.1–8%), prior to counselling.  The impact of counselling was clearly noted by the significant (P<0.005) change of HbA_1C level within the normal limits with the mean values ranging between 6.4–6.9% in both the strata. A significant difference (P<0.01) in between the two strata prior to counselling was observed only in obese category; whereas after the counseling, a nonsignificant difference was noted between the two strata.

Keywords: non-insulin dependent diabetics, type 2 diabetes, nutritional counselling, body mass index, glycosylated hemoglobin.