The impact of the Mediterranean diet and close monitoring on glycemic control and weight management in poorly controlled type 2 diabetes
Mediterranean Journal of Nutrition and Metabolism, cilt.18, sa.3, ss.176-183, 2025 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.1177/1973798x251349603
- Dergi Adı: Mediterranean Journal of Nutrition and Metabolism
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE
- Sayfa Sayıları: ss.176-183
- Anahtar Kelimeler: healthy lifestyle, medication adherence, weight loss, Mediterranean diets
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Despite the increasing availability of medications for managing type 2 diabetes mellitus (T2DM), a significant proportion of patients fail to achieve optimal glycemic control. Objective: This study aimed to evaluate adherence to treatment and lifestyle recommendations and their association with achieving diabetes management goals after a 12-month structured follow-up program. Methods: In this retrospective cohort study, adults with poorly controlled T2DM (baseline HbA1c ≥ 10%) who completed a 12-month follow-up were analyzed. The program included close monitoring, structured education, and lifestyle guidance. The Mediterranean Diet Adherence Screener (MEDAS) was employed to evaluate participants’ adherence to the Mediterranean diet. The primary outcomes were overall adherence to lifestyle recommendations and its association with variations in HbA1c and body weight. Results: The study included 127 patients (58.3% male) with a mean age of 55.4 ± 10.6 years, and baseline HbA1c of 12.1 ± 1.8%. At 12 months, 92.1% of patients achieved an HbA1c reduction, with a mean change of −3.8 ± 2.8% (p < 0.001). Weight loss was observed in 52.8% of patients, with a mean change of −0.9 ± 8.2 kg (p = 0.064). Medication adherence increased from 52.8% to 84%, but only 22.8% of patients consulted a diabetes specialist dietitian. The mean MEDAS score was 6.4 ± 1.9, with 26% of patients categorized as low, 66.7% as moderate, and 6.3% as high. MEDAS scores were not associated with changes in HbA1c or body weight (p = 0.248 and p = 0.732 respectively). Conclusion: While promoting healthy lifestyle behaviors and medication adherence improves glycemic control in poorly controlled diabetes, adherence to the Mediterranean diet and achieving substantial weight loss remain challenging.