A computer program has been developed that has the capability to plan menus for diabetic patients. Program input includes the patient's diet prescription, usual daily meal pattern, and food preferences. The program uses a food selection algorithm that combines patient food preferences and randomization to produce menus that include foods the patient likes and that vary from day to day. The amount of each food item served at a meal is determined by an integer programming algorithm that satisfies the dietary prescription. Program output includes daily menus, weekly nutrient summaries, and a weekly shopping list. The menus includes for each food item: food name, amount in household units, numbers and types of exchanges, calories, and a space in which to write exchanges. The menu serves as a diet plan, exchange concept instructional model, and diabetic diary.

Computers↗

PubMedDate not supplied

Evaluation of computer-based diet education in persons with diabetes mellitus and limited educational background.

A study was conducted to determine whether computer-based techniques for meal planning and diet education could be an effective supplement to diabetes diet counseling in a group of inner-city subjects with limited educational background. Sixteen individuals with diabetes mellitus who were newly referred to an inner-city outpatient diet clinic and who demonstrated ninth-grade reading ability were given computer-based nutritional education. They received meal planning information through use of individualized computer-planned menus and education about the diabetes diet by computer-assisted instruction (CAI) combined with an interactive videodisc system (VIDEO). Total contact time was 180 min of CAI/VIDEO, 50 min of dietitian/patient education, and 20 min of dietitian/patient computer time (the last function could have been performed by a clerk). At the end of 4 wk, the group performance was improved in Exchange Lists knowledge (P less than 0.001), recognition of foods containing concentrated carbohydrate (P less than 0.05), and reduction of reported fat intake (P less than 0.05). In addition, average group weight declined by 4.6 lb (P less than 0.005). No improvement was found in food-measuring skills or in calorie-consumption compliance during a standardized buffet lunch. It appears that computer-based techniques are an acceptable supplement to traditional methods of education in this patient group and can improve the effectiveness of diabetes education programs without a significant increase in dietitian time.

Adult↗

PubMedDate not supplied

The diabetes education study: a controlled trial of the effects of diabetes patient education.

The Diabetes Education Study (DIABEDS) was a randomized, controlled trial of the effects of patient and physician education. This article describes a systematic education program for diabetes patients and its effects on patient knowledge, skills, self-care behaviors, and relevant physiologic outcomes. The original sample consisted of 532 diabetes patients from the general medicine clinic at an urban medical center. Patients were predominantly elderly, black women with non-insulin-dependent diabetes mellitus of long duration. Patients randomly assigned to experimental groups (N = 263) were offered up to seven modules of patient education. Each content area module contained didactic instruction (lecture, discussion, audio-visual presentation), skill exercises (demonstration, practice, feedback), and behavioral modification techniques (goal setting, contracting, regular follow-up). Two hundred seventy-five patients remained in the study throughout baseline, intervention, and postintervention periods (August 1978 to July 1982). Despite the requirement that patients demonstrate mastery of educational objectives for each module, postintervention assessment 11-14 mo after instruction showed only rare differences between experimental and control patients in diabetes knowledge. However, statistically significant group differences in self-care skills and compliance behaviors were relatively more numerous. Experimental group patients experienced significantly greater reductions in fasting blood glucose (-27.5 mg/dl versus -2.8 mg/dl, P less than 0.05) and glycosylated hemoglobin (-0.43% versus + 0.35%, P less than 0.05) as compared with control subjects. Patient education also had similar effects on body weight, blood pressure, and serum creatinine. Continued follow-up is planned for DIABEDS patients to determine the longevity of effects and subsequent impact on emergency room visits and hospitalization.

Blood Glucose↗