THE RELATIONSHIP BETWEEN EATING PATTERNS AND METABOLIC CONTROL IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS (NIDDM)

The most important element in the therapeutic plan of patients with no n-insulin-dependent diabetes mellitus (NIDDM) is dietary modification. Dietary instructions target patient behaviors in two areas: following an exchange-based diet and adhering to the same basic eating pattern every day. However, there is little empirical data that addresses the relationship between dietary instruction and metabolic control. Fifty patients with NIDDM were enrolled in an 8-week study to ascertain if e ither dietary approach was more predictive of improved metabolic contr ol. The effect on metabolic control was determined by changes in HbA(l c) over a 2- to 3-month period. Patients added or deleted almost half of all prescribed exchanges, and added or deleted an average of one pr escribed meal or snack per day. Deviations in prescribed eating patter ns, particularly breakfast-skipping and snack additions and deletions, were related to poorer metabolic control. Maintaining consistent eati ng patterns should be further evaluated as an important component of d ietary instruction for patients with NIDDM.