Effectiveness of medical nutrition treatment delivered by dietitians on glycaemic outcomes and lipid profiles of Arab, Omani patients with Type 2 diabetes

Aims In this randomized controlled trial we evaluated the effectiveness of medical nutritional therapy on Arab patients with Type 2 diabetes in Oman delivered by a dietitian. Methods Patients with Type 2 diabetes (n = 170) were randomly assigned to a group receiving usual nutritional care (n = 85) or a group receiving practice guidelines nutritional care (n = 85). Anthropometric (weight, height, BMI and waist circumference) and biochemical (fasting blood glucose, HbA1c) variables were measured at baseline and after each appointment. Patients were given 13 appointments with a dietitian over 6 months. Results Those in the group receiving practice guidelines nutritional care (n = 85) had significant changes in HbA1c (-0.8%, P = 0.001), fasting plasma glucose (-1.3 mmol\l, P = 0.003) and weight (-5.1 kg, P = 0.05), whereas the patients in the usual nutritional care group (n = 85) had no significant improvements in either HbA1c (-0.4%, P = 0.248) or fasting plasma glucose (-0.2 mmol/l, P = 0.638) during the same period. We also found a significant difference between the group receiving practice guidelines nutritional care and the usual nutritional care group, respectively, in waist circumference (96.9 +/- 7.9 vs. 100.0 +/- 8.7 cm, P = 0.019), triglycerides levels (1.42 +/- 0.58 vs. 1.98 +/- 0.96 mmol\l, P = 0.001), cholesterol levels (5.1 +/- 1.0 vs. 5.5 +/- 0.9 mmol/l, P = 0.009) and LDL cholesterol levels (3.58 +/- 0.98 vs. 3.89 +/- 0.98 mmol/l, P = 0.046). Conclusions Medical nutrition therapy provided by dietitians to Arab patients with Type 2 diabetes in Oman resulted in significant improvements in anthropometric and biochemical outcomes in both the usual nutritional care group and the group receiving practice guidelines nutritional care. Subjects with Type 2 diabetes tended to do better with practice guidelines nutritional care than with usual nutritional care. Ongoing medical counselling in nutrition by a trained dietitian is important for better long-term metabolic control.