Plate-restricted diet affords short-term improvements in glycaemic control

Restricting diet with a plate is as good as carbohydrate counting in terms of short-term glycaemic control, with an added benefit of curbing weight gain and lipid level increase, according to a study.

A total of 419 patients (50.3 percent female) with type 2 diabetes mellitus residing in Nanjing, China, were randomized to undergo a dietary intervention by either the plate model (n=210, mean age 48.6 years) or the counting model (n=209, mean age 46.3 years).

The plate model included three components: (1) a low-literacy, colour leaflet containing the explanation and food composition of the plate during meals, health education, and medical visits. The counting model also involved health education, medical visits, and a paper booklet containing traditional carbohydrate counting education.

HbA1c decreased by 0.7 percent in the first 3 months and by 1.44 percent at 6 months, but slightly increased at 12 months, for patients in the plate model. Moreover, compared with the counting model, the plate model was associated with a significant reduction in fasting plasma glucose (FPG; 9.25 percent vs 7.44 percent; p=0.008) and 2-hour postprandial glucose (2hPG) values (12.07 percent vs 8.35 percent; p=0.004).

Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels also dropped significantly in the plate group, occurring at 6 months and maintained through 12 months. The average weight loss in the plate group was 1.2 kg/month (95 percent confidence interval [CI], 0.92–1.48) in the first 3 months, while the average weight gain in the fourth to 12th month was 0.21 kg/month (95 percent CI, 0.08–0.34).

There was significant difference in education time between the groups (17.3 v. 38.6; p<0.001).

The findings suggest that the plate model has the potential to improve diabetes education among those with low health literacy by reducing reading demands.