THE MAINTENANCE OF IMPROVED METABOLIC CONTROL AFTER INTENSIFIED DIET THERAPY IN RECENT TYPE-2 DIABETES

Altogether 86 patients with recently diagnosed NIDDM, aged 40-64 years were randomised after 3 months of basic education to intensified diet (Int. group, 21 men, 19 women) or conventional treatment groups (Conv . group, 28 men, 18 women). The aim was to examine whether an intensif ied diet education would result in a better metabolic control and grea ter reduction in cardiovascular risk factors than conventional treatme nt for obese patients with recently diagnosed type 2 diabetes mellitus . Furthermore, both groups were re-examined after a second year of obs ervation period to find out the maintenance of the results after inter vention. After basic education, Int. group participated in 12-months d iet education, while Conv. group was treated in local health centres. During the intervention period, only Int. group showed further weight reduction. Only 20% of patients in Int. and 6% of patients in Conv. gr oup had BMI < 27 kg/m2 at the end of the intervention, while 75% of pa tients in Int. and 52% of patients in Conv. group had achieved a good metabolic control (fasting blood glucose < 6.7 mmol/l; P = 0.005 betwe en groups). Serum total cholesterol did not change significantly, but the changes in HDL-cholesterol, triglycerides and apolipoprotein B lev el were significant in Int. group only. The proposed acceptable values for serum lipids were achieved by 52 to 88% of patients without major differences between the two groups. During the second year of observa tion weight gained in both groups and a deterioration was seen in meta bolic control. Despite that a greater proportion of patients in the In t. group still was in good metabolic control (55.3% vs. 31.8%, P = 0.0 16), furthermore Int. group was receiving less frequently oral drugs f or hyperglycaemia than Conv. group. No differences in serum lipids wer e observed between the groups after the observation period. HDL-choles terol showed a persistent improvement in both groups.