Restriction of Rice Portion and Consumption Pre-Meal Fruit with HbA1c Levels and Abdominal Fat for Type 2 Diabetes Mellitus Patient in Malang City
Pembatasan Porsi Nasi dan Konsumsi Buah Sebelum Makan dengan Kadar HbA1c dan Lemak Perut Penderita Diabetes Mellitus Tipe-2 di Kota Malang
Downloads
Background: Glycemic control is the basis for managing diabetes to prevent chronic complications in diabetes.HbaA1c levels reaching ≤7% is an indicator of achieving good glycemic control. The 3J principles (right type, amount, and schedule) in the pillars of meal management are not easy to apply, causing diabetes to have difficulty achieving glycemic targets.
Objectives: Analyzing rice portion restriction and pre-meal fruit with HbA1c levels and abdominal fat in people with diabetes in Malang City.
Methods: Experimental study type 'randomized controlled trial' with pre-posttest control group design involved 16 people with diabetes who were active in Prolanis activities at the Malang city health center. Respondents were randomly divided into 2 groups. HbA1c levels were taken 2 times, before and after the intervention. The t test and paired t test with a pvalue<0.05 were used to test the effect of the intervention on HbA1c levels, abdominal fat and abdominal circumference in people with diabetes for 3 months.
Results: Both forms of intervention can reduce HbA1c levels in diabetic patients. Limiting the portion of rice significantly reduced HbA1c levels (p=0.003) and visceral fat levels. However, determining the amount of rice with added pre-meal fruit did not significantly decrease visceral fat and abdominal circumference (p>0.05).
Conclusions: Limiting the portion of rice eaten by itself or combining it with pre-meal fruit may help diabetics lower their HbA1c levels.
Martinez, M., Santamarina, J., Pavesi, A., Musso, C. & Umpierrez, GE Glycemic variability and cardiovascular disease in patients with type 2 diabetes.BMJ Open Diab Res Care9, e002032 (2021).
Scott, E.Set al.Long-Term Glycemic Variability and Vascular Complications in Type 2 Diabetes: Post Hoc Analysis of the FIELD Study. The Journal of Clinical Endocrinology & Metabolism 105, e3638–e3649 (2020).
Raghavan, S.et al.Diabetes Mellitus–Related All"Cause and Cardiovascular Mortality in a National Cohort of Adults. JAHA 8, e011295 (2019).
Haghighatpanah, M., Nejad, ASM, Haghighatpanah, M., Thunga, G. & Mallayasamy, S. Factors that Correlate with Poor Glycemic Control in Type 2 Diabetes Mellitus Patients with Complications.Osong Public Health Research Perspect9, 167–174 (2018).
Sherwani, SI, Khan, HA, Ekhzaimy, A., Masood, A. & Sakharkar, MK Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients.Biomark�Insights11, BMI.S38440 (2016).
Bonsembiante, L., Targher, G. & Maffeis, C. Type 2 Diabetes and Dietary Carbohydrate Intake of Adolescents and Young Adults: What Is the Impact of Different Choices?Nutrients13, 3344 (2021).
Kang,et al.Effects of Different Proportion of Carbohydrates in Breakfast on Postprandial Glucose Excursion in Normal Glucose Tolerance and Impaired Glucose Regulation Subjects. Diabetes Technology & Therapeutics 15, 569–574 (2013).
Soebagijo Adi Soelistijo. Guidelines for the management and prevention of adult type 2 diabetes mellitus in INDONESIA - 2021. (2021).
Malang City Health Office. Malang City Health Profile in 2022. (2023).
Malang City Health Office. Malang City Health Profile in 2021. (2022).
Malang City Health Office. Malang City Health Profile 2020. (2021).
Imai, S.et al.A simple meal plan of 'eating vegetables before carbohydrate' was more effective for achieving glycemic control than an exchange–based meal plan in Japanese patients with type 2 diabetes.
Kubota, S.et al.A Review of Recent Findings on Meal Sequence: An Attractive Dietary Approach to Prevention and Management of Type 2 Diabetes. Nutrients 12, 2502 (2020).
Kuwata, H.et al.Meal sequence and glucose excursion, gastric emptying and incretin secretion in type 2 diabetes: a randomised, controlled crossover, exploratory trial. Diabeologia 59, 453–461 (2016).
Shukla, APet al.The impact of food orders on postprandial glycemic excursions in prediabetes. Diabetes Obesity Metabolism 21, 377–381 (2019).
Nesti, L., Mengozzi, A. & Tricò, D. Impact of Nutrient Type and Sequence on Glucose Tolerance: Physiological Insights and Therapeutic Implications.Front. Endocrinol.10, 144 (2019).
Indarto, D., Dwipajati, D., Dirgahayu, P., Wibowo, YC & Pratama, YM Acute Effects of Breakfast Fruits Meal Sequence and Postprandial Exercise on the Blood Glucose Level and DPP4 Activity among Type 2 Diabetes Mellitus Patients: A Pilot Study .Journal of Obesity2022, 1–8 (2022).
Dwipajati, D., Indarto, D. & Dirgahayu, P. Reduction of Dipeptidyl Peptidase 4 Activity in Patients with Type 2 Diabetes Mellitus Who Consume Fruits Before Meals.ATMPH22, 01–09 (2019).
Abdul Hakim, BN, Yahya, HM, Shahar, S., Abdul Manaf, Z. & Damanhuri, H. Effect of Sequence of Fruit Intake in a Meal on Satiety.IJERPH16, 4464 (2019).
Halvorsen, R.E., Elvestad, M., Molin, M. & Aune, D. Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of prospective studies.BMJNPH4, 519–531 (2021).
Giuntini, EB, Sardá, FAH & de Menezes, EW The Effects of Soluble Dietary Fibers on Glycemic Response: An Overview and Futures Perspectives.Foods11, 3934 (2022).
Mishra, S., McLaughlin, A. & Monro, J. Food Order and Timing Effects on Glycaemic and Satiety Responses to Partial Fruit-for-Cereal Carbohydrate Exchange: A Randomized Cross-Over Human Intervention Study.Nutrients15, 3269 (2023).
Goff, H.D., Repin, N., Fabek, H., El Khoury, D. & Gidley, MJ. Dietary fiber for glycaemia control: Towards a mechanistic understanding.Bioactive Carbohydrates and Dietary Fiber14, 39–53 (2018).
Thomsen, M.Net al.Dietary carbohydrate restriction augments weight loss-induced improvements in glycaemic control and liver fat in individuals with type 2 diabetes: a randomized controlled trial. Diabeologia 65, 506–517 (2022).
Lennerz, BS, Koutnik, AP, Azova, S., Wolfsdorf, JI & Ludwig, DS Carbohydrate restriction for diabetes: rediscovering centuries-old wisdom.Journal of Clinical Investigation131, e142246 (2021).
Huntriss, R., Boocock, R. & McArdle, P. Dietary carbohydrate restriction as a management strategy for adults with type 2 diabetes: Exploring the opinions of dietitians.23,.
Indonesian Ministry of Health. Guide to Implementing the Archipelago Movement to Reduce Obesity Rates (GENTAS). (2017).
Maneesing, T.et al.Optimizing blood glucose control with portioned meal boxes in type 2 diabetes mellitus patients: a randomized control trial. Front. Nutr. 10, 1216753 (2023).
Bowen, M.Eet al.The diabetes nutrition education study randomized controlled trial: A comparative effectiveness study of approaches to nutrition in diabetes self-management education. Patient Education and Counseling 99, 1368–1376 (2016).
Jeremy D Krebset al.A randomized trial of the feasibility of a low carbohydrate diet vs standard carbohydrate counting in adults with type 1 diabetes taking body weight into account. Asia Pacific Journal of Clinical Nutrition 25, (2016).
Nicholas, AP, Soto-Mota, A., Lambert, H. & Collins, AL Restricting carbohydrates and calories in the treatment of type 2 diabetes: a systematic review of the effectiveness of 'low-carbohydrate' interventions with differing energy levels.J Nutr Sci10, e76 (2021).
Feng, Y.et al.A practical "low-carbohydrate dietary care” model for elderly patients with type 2 diabetes mellitus. Food Sci. Technol 42, e77222 (2022).
Goldstein, T.et al.The effect of a low carbohydrate energy-unrestricted diet on weight loss in obese type 2 diabetes patients – A randomized controlled trial. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism 6, e178–e186 (2011).
Charan, J. & Biswas, T. How to Calculate Sample Size for Different Study Designs in Medical Research?Indian Journal of Psychological Medicine35, 121–126 (2013).
Indonesian Ministry of Health. Regulation of the Minister of Health of the Republic of Indonesia Number 41 of 2014 concerning Guidelines for Balanced Nutrition. (2014).
Lukito, AA & Harmeiwaty, E. Association of Indonesian Hypertension Doctors. (2019).
Petrie, JR, Guzik, TJ & Touyz, RM Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms.Canadian Journal of Cardiology34, 575–584 (2018).
Ele Ferrannini, VT Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories.IJPHRD13, (2022).
El Meouchy, P.et al.Hypertension Related to Obesity: Pathogenesis, Characteristics and Factors for Control. IJMS 23, 12305 (2022).
Alsaadon, H.et al.Hypertension and its related factors among patients with type 2 diabetes mellitus – a multi-hospital study in Bangladesh. BMC Public Health 22, 198 (2022).
Soviana, E. & Maenasari, D. FIBER INTAKE, GLYCEMIC LOAD AND BLOOD GLUCOSE LEVELS IN TYPE 2 DIABETES MELLITUS PATIENTS.JK12, 19–29 (2019).
Abdurrachim, R. & Annisa, RD Fiber intake and physical exercise contribute to blood glucose levels in outpatients with type 2 diabetes mellitus.IJND5, 66 (2018).
Yen, T.Set al.Increased vegetable intake improves glycemic control in adults with type 2 diabetes mellitus: a clustered randomized clinical trial among Indonesian white-collar workers. J Nutr Sci 11, e49 (2022).
Butler, A.Eet al.Effect of Date Fruit Consumption on the Glycemic Control of Patients with Type 2 Diabetes: A Randomized Clinical Trial. Nutrients 14, 3491 (2022).
Ebe, K. Daily carbohydrate intake correlates with HbA1c in low carbohydrate diet (LCD).1, (2017).
Merrill, J.Det al.Low-Carbohydrate and Very-Low-Carbohydrate Diets in Patients With Diabetes. Diabetes Spectrum 33, 133–142 (2020).
American Diabetes Association.Standards of Medical Care in Diabetes”2022Abridged for Primary Care Providers. Clinical Diabetes 40, 10–38 (2022).
Perkeni. Guidelines for the management and prevention of adult type 2 diabetes mellitus in INDONESIA - 2021. 119 (2021).
Mohammed, AS, Adem, F., Tadiwos, Y., Woldekidan, NA & Degu, A. Level of Adherence to the Dietary Recommendation and Glycemic Control Among Patients with Type 2 Diabetes Mellitus in Eastern Ethiopia: A Cross-Sectional Study.DMSOVolume 13, 2605–2612 (2020).
Abdelsalam, S.et al.Perceived Adherence and Barriers to Dietary Recommendations among Type 2 Diabetic Patients in a Family Practice Clinic, Suez Canal University Hospitals. The Egyptian Family Medicine Journal 6, 95–107 (2022).
Capuano, E. The behavior of dietary fiber in the gastrointestinal tract determines its physiological effects.Critical Reviews in Food Science and Nutrition57, 3543–3564 (2017).
Cherta-Murillo, A.et al.The effects of SCFAs on glycemic control in humans: a systematic review and meta-analysis. The American Journal of Clinical Nutrition 116, 335–361 (2022).
Chait, A. & Den Hartigh, LJ Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease.Front. Cardiovasc. Med.7, 22 (2020).
Longo, M.et al.Adipose Tissue Dysfunction as a Determinant of Obesity-Associated Metabolic Complications. IJMS 20, 2358 (2019).
Koopman, K.Eet al.Hypercaloric diets with increased meal frequency, but not meal size, increase intrahepatic triglycerides: A randomized controlled trial. Hepatology 60, 545–553 (2014).
Mohan, V.et al.Are excess carbohydrates the main link to diabetes & its complications in Asians? Indian J Med Res 148, 531 (2018).
Sharma, S., Chung, H., Kim, H. & Hong, S. Paradoxical Effects of Fruit on Obesity.Nutrients8, 633 (2016).
Monteiro-Alfredo, T.et al.Distinct Impact of Natural Sugars from Fruit Juices and Added Sugars on Caloric Intake, Body Weight, Glycaemia, Oxidative Stress and Glycation in Diabetic Rats. Nutrients 13, 2956 (2021).
Guyenet, SJ Impact of Whole, Fresh Fruit Consumption on Energy Intake and Adiposity: A Systematic Review.Front. Nutr.6, 66 (2019).
Breyton, A.-E., Lambert-Porcheron, S., Laville, M., Vinoy, S. & Nazare, J.-A. CGMS and Glycemic Variability, Relevance in Clinical Research to Evaluate Interventions in T2D, a Literature Review.Front. Endocrinol.12, 666008 (2021).
Ceriello, A. Glucose Variability and Diabetic Complications: Is It Time to Treat?Diabetes Care43, 1169–1171 (2020).
Smith-Palmer, J.et al.Assessment of the association between glycemic variability and diabetes-related complications in type 1 and type 2 diabetes. Diabetes Research and Clinical Practice 105, 273–284 (2014).
Moon, J., Kim, JY, Yoo, S. & Koh, G. Fasting and Postprandial Hyperglycemia: Their Predictors and Contributions to Overall Hyperglycemia in Korean Patients with Type 2 Diabetes.Endocrinol Metab35, 290–297 (2020).
Monnier, L., Colette, C. & Owens, D. Glucose variability and diabetes complications: Risk factor or biomarker? Can we untangle the "Gordian Knot”?Diabetes & Metabolism47, 101225 (2021).
Ridwanto, M., Indarto, D. & Hanim, D. Factors Affecting Fasting Blood Glucose in Patients with Type 2 Diabetes Mellitus.International Journal of Nutrition Sciences5, (2020).
Hiyoshi, T., Fujiwara, M. & Yao, Z. Postprandial hyperglycemia and postprandial hypertriglyceridemia in type 2 diabetes.J Biomed Res33, 1 (2019).
Galicia-Garcia, U.et al.Pathophysiology of Type 2 Diabetes Mellitus. IJMS 21, 6275 (2020).
Bai, Q.et al.Effects of consumption of a low glycaemic index formula on glycaemic control in patients with type 2 diabetes managed by medical nutrition therapy. Food Sci. Technol 41, 768–774 (2021).
Yoshimura, E.et al.Relationship between intra-individual variability in nutrition-related lifestyle behaviors and blood glucose outcomes under free-living conditions in adults without type 2 diabetes. Diabetes Research and Clinical Practice 196, 110231 (2023).
Alonso-Bastida, A.et al.Impact on Glycemic Variation Caused by a Change in the Dietary Intake Sequence. Foods 12, 1055 (2023).
Tricò, D., Filice, E., Trifirò, S. & Natali, A. Manipulating the sequence of food ingestion improves glycemic control in type 2 diabetic patients under free-living conditions.Nutr & Diabetes6, e226–e226 (2016).
Bonsembiante, L., Targher, G. & Maffeis, C. Type 2 Diabetes and Dietary Carbohydrate Intake of Adolescents and Young Adults: What Is the Impact of Different Choices?Nutrients13, 3344 (2021).
Imai, S., Fukui, M. & Kajiyama, S. on glucose excursions in patients with type 2 diabetes.
Petrie, JR, Guzik, TJ & Touyz, RM Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms.Canadian Journal of Cardiology34, 575–584 (2018).
Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories.IJPHRD13, (2022).
Abdul Hakim, BN, Yahya, HM, Shahar, S. & Abdul Manaf, Z. Influence of Fruit and Vegetable Intake on Satiety and Energy Intake: A Review.JSM47, 2381–2390 (2018).
Giuntini, EB, Sardá, FAH & De Menezes, EW The Effects of Soluble Dietary Fibers on Glycemic Response: An Overview and Futures Perspectives.Foods11, 3934 (2022).
Abdul Hakim, BN, Yahya, HM, Shahar, S., Abdul Manaf, Z. & Damanhuri, H. Effect of Sequence of Fruit Intake in a Meal on Satiety.IJERPH16, 4464 (2019).
Cherta-Murillo et al. - 2022 - The effects of SCFAs on glycemic control in humans.pdf.
Copyright (c) 2024 Amerta Nutrition
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
AMERTA NUTR by Unair is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.