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Managing Diabetes? Factor In Cultural Influences 

Managing Type 2 diabetes is not one-size-fits-all. A new study shows tailoring care plans to include cultural factors could help improve health outcomes.

Managing diabetes with diet plans
Oct 25 2016

More than 415 million adults worldwide have diabetes today, and that number is expected to rise to 642 million by 2040. To help people manage their diabetes, experts recommend regular health appointments, exercise and proper nutrition to manage a healthy weight.

To create a personalized diabetes management plan, healthcare providers around the world have access to algorithms—or more simply put, a set of steps and guidelines. A new study, presented at the annual conference of American Diabetes Association, showed that creating a plan that takes your culture into consideration—such as local diets, eating habits and genes—could help people reach their health goals including lowering A1C levels and body weight.

The Impact of Personalized Care Plans

Led by independent researcher Professor Winnie Chee at the International Medical University in Malaysia, the study followed 230 people with type-2 diabetes who were not using insulin. One group received the transcultural care plan, known to the medical community as tDNA.

Developed with diabetes experts around the world, including Abbott, the tDNA algorithm allows doctors to create a plan that takes into account a person’s cultural nutritional and lifestyle habits, food availability and even genetics, along with their body weight, A1C level, fitness capacity and cardiovascular risk factors.

During the study, the group who received the algorithm-created plan also received a low-calorie meal plan which included 1-2 servings of a diabetes-specific nutrition drink per day, as well as counselling and increased exercise. The other randomized group received a similar low-calorie meal plan, and received the same amount of exercise.

Researchers found that the group who followed the structured plan had a larger decrease in the following when compared to the control group on the low-calorie meal plan:*

  • Body weight loss
  • A1C levels
  • Fasting blood glucose
  • Blood pressure

"By building a diabetes management plan that factors in real-life influences, a physician can help tailor a plan that a patient can follow," said Professor Chee. “But it does require teamwork. Doctors can connect their patients with dietitians and nurse educators to collectively come up with a plan that works for each person’s individual needs."

Making Changes Can Start With You

So what can people do? Rachel Johnson, a registered dietitian who specializes in diabetes nutrition, offered some tips for people managing their type-2 diabetes:

  • Start with small, manageable lifestyle changes that include exercise and nutrition.

  • Speak with your doctor about challenges you are facing – while the internet is a wealth of information, it may not take into consideration some of the cultural and lifestyle barriers in the way.

  • When it makes sense, consider using a specialized diabetes-specific nutrition drink like Glucerna to help manage diabetes.

"When a person has been diagnosed with diabetes, it doesn’t mean that person has to stop the joy of having food he or she loves or change the eating habits against the cultural traditions," said Johnson. "By making simply lifestyle changes – from a brief walk for 30 minutes to learning to eat heathier using local ingredients and flavors— you can find a balance to living a healthier life."

*Actual numbers when compared to the baseline:

  • Weight: tDNA -3.9 ± 0.2 kg, p<0.001; usual care -0.6± 0.2 kg; p=0.012).
  • A1C level: tDNA group -0.8 ±0.1%, p<0.001; usual care -0.2±0.1%; p=0.046. 
  • Fasting blood glucose: tDNA -0.7±0.3,p=0.006; usual care 0.1±0.3,p=0.656
  • Blood pressure: systolic: tDNA -9.5±1.5, p<0.001; usual care -1.0±1.8,p =0.571.
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