208-OR: Impact of Carbohydrate-Restricted Nutrition Therapy and Continuous Remote Care among People with Type 2 Diabetes in Rural vs. Urban Areas (2024)

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Volume 73, Issue Supplement_1

June 2024

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OR: Epidemiology—Nutrition| June 14 2024

SHAMINIE J. ATHINARAYANAN;

SHAMINIE J. ATHINARAYANAN

West Lafayette, IN, San Francisco, CA, Denver, CO

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REBECCA N. ADAMS;

CAROLINE G.P. ROBERTS;

CAROLINE G.P. ROBERTS

West Lafayette, IN, San Francisco, CA, Denver, CO

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BRITTANIE M. VOLK;

BRITTANIE M. VOLK

West Lafayette, IN, San Francisco, CA, Denver, CO

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ALISON ZOLLER;

ALISON ZOLLER

West Lafayette, IN, San Francisco, CA, Denver, CO

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AMY L. MCKENZIE

AMY L. MCKENZIE

West Lafayette, IN, San Francisco, CA, Denver, CO

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Diabetes 2024;73(Supplement_1):208-OR

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SHAMINIE J. ATHINARAYANAN, REBECCA N. ADAMS, CAROLINE G.P. ROBERTS, BRITTANIE M. VOLK, ALISON ZOLLER, AMY L. MCKENZIE; 208-OR: Impact of Carbohydrate-Restricted Nutrition Therapy and Continuous Remote Care among People with Type 2 Diabetes in Rural vs. Urban Areas. Diabetes 14 June 2024; 73 (Supplement_1): 208–OR. https://doi.org/10.2337/db24-208-OR

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Diabetes outcomes and complications are often worse in rural (R) versus urban (U) areas, commonly due to challenges accessing health services. Our telemedicine clinic aims to address these barriers, offering carbohydrate-restricted nutrition therapy via continuous remote care for people with type 2 diabetes (T2D) nationwide. This retrospective analysis assessed the 1 year (y) effects of this care model on cardiometabolic markers in people with T2D from R and U counties. 74.7% R and 74.1% U were enrolled at least 1y in the clinic at time of analysis; a random sample of 800 was identified from each cohort. Changes from enrollment (E) to 1y were assessed with linear mixed effect models or logistic regression, as appropriate. Characteristics at E were consistent between R and U (Table 1). No differences between R and U areas were observed (ps>0.05). In both R and U at 1y, HbA1c, weight, HDL-C, triglycerides, and liver enzymes improved, total cholesterol was unchanged, and LDL-C slightly increased within normal limits. There was no difference between R and U in attainment of HbA1c <8% and LDL-C <100 mg/dL at E and 1y. Patients in R areas were 20% less likely [OR: 0.80 (0.64, 0.99), p=0.04] to attain TG<150 mg/dL vs U at E, but after 1 y, this disparity was closed [OR: 0.85(0.67, 1.08)]. These results show that this care model improves real-world cardiometabolic health in T2D in R and U areas.

208-OR: Impact of Carbohydrate-Restricted Nutrition Therapy and Continuous Remote Care among People with Type 2 Diabetes in Rural vs. Urban Areas (2)

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208-OR: Impact of Carbohydrate-Restricted Nutrition Therapy and Continuous Remote Care among People with Type 2 Diabetes in Rural vs. Urban Areas (3)

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Disclosure

S.J. Athinarayanan: Employee; Virta Health Corp. R.N. Adams: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. C.G.P. Roberts: Other Relationship; Virta Health Corp. B.M. Volk: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A. Zoller: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.L. McKenzie: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. Employee; Abbott.

© 2024 by the American Diabetes Association

2024

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

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208-OR: Impact of Carbohydrate-Restricted Nutrition Therapy and Continuous Remote Care among People with Type 2 Diabetes in Rural vs. Urban Areas (2024)

FAQs

What is nutrition therapy's role in the treatment of diabetes mellitus? ›

People with diabetes should receive nutrition counselling by a registered dietitian. Nutrition therapy can reduce glycated hemoglobin (A1C) by 1.0% to 2.0% and, when used with other components of diabetes care, can further improve clinical and metabolic outcomes.

What kind of support is available for people with diabetes? ›

The Association of Diabetes Care and Education Specialists can help you learn how to make changes in lifestyle to delay or prevent type 2 diabetes by focusing on eating healthy, adding physical activity to your life, dealing with stress, coping with challenges that can derail your hard work, and getting back on track ...

What is diabetes mellitus according to the American Diabetes Association? ›

Diabetes (diabetes mellitus (MELL-ih-tus)) A condition where the body's blood glucose (blood sugar) levels are higher than normal (hyperglycemia) resulting from the body's inability to use or store blood glucose for energy.

What are the nutritional standards of care for diabetes? ›

In adults with diabetes, the macronutrient distribution as a percentage of total energy can range from 45% to 60% carbohydrate, 15% to 20% protein, and 20% to 35% fat to allow for individualized nutrition therapy according to preferences and treatment goals.

What should the goals of nutrition therapy for the patient with type 2 diabetes include? ›

The aims of treatment for T2D are to lose weight, normalize fasting and postprandial blood glucose and hemoglobin A1c values, identify and treat associated comorbidities such as hypertension and hyperlipidemia, and to minimize the risk of acute and chronic complications associated with diabetes.

What are the general nutrition therapy recommendations for type 2 diabetes? ›

In general, it's a good idea to get protein from lean meats, fish, eggs, beans, soy, and nuts, and to limit the amount of red meat you eat. Eating a diet that is high in fiber may help you manage your blood sugar levels. (See "Patient education: High-fiber diet (Beyond the Basics)".)

How do support groups help people with diabetes? ›

Whether informal or structured, in-person or online, one-to-one or in a group, connecting with other people dealing with diabetes can be relieving, encouraging, and empowering. Support can offer a sense of being understood. It can provide opportunities to share wisdom and practical information.

What are the treatments and other support available for individuals with diabetes nutritional? ›

Taking insulin or other diabetes medicines is often part of treating diabetes. In addition to making healthy food and beverage choices, getting physical activity, getting enough sleep, and managing stress, medicines can help you manage the disease.

What is borderline diabetes? ›

Prediabetes means that your blood sugars are higher than usual, but not high enough for you to be diagnosed with type 2 diabetes. It also means that you are at high risk of developing type 2 diabetes. You are unlikely to be experiencing any symptoms with prediabetes.

Is peanut butter good for diabetics? ›

Peanut butter contains essential nutrients, and it can be part of a healthful diet when a person has diabetes. However, it is important to eat it in moderation, as it contains a lot of calories. People should also make sure their brand of peanut butter is not high in added sugar, salt, or fat.

Are bananas good for diabetics? ›

Though bananas are higher in carbs and sugars than some foods, they also contain fiber and resistant starch that slows down the digestion and release of sugar into your bloodstream. These qualities make bananas a healthy, go-to snack for people with diabetes.

What is the role of nutrition in diabetes mellitus? ›

Eating the correct type of food in the right quantities helps keep your blood glucose levels within an acceptable range. A balanced diet can also help avoid weight gain, which can be a significant risk factor for developing complications from diabetes.

What is the nutrition care process for diabetes mellitus? ›

The NCP model has four steps and these are nutrition assessment and reassessment, diagnosis, intervention, and monitoring and evaluation. The first two steps identify the nutrition problem, and the last two solve or manage the identified problem.

What is the role of the nutritional plan in the management of diabetes? ›

The plan helps you control your blood sugar, also called blood glucose, manage your weight and control heart disease risk factors. These factors include high blood pressure and high blood fats. When you eat extra calories and carbohydrates, your blood sugar levels rise.

What are the goals of nutritional care for persons with diabetes mellitus? ›

Limit intake of saturated fats by cutting back on processed and fast foods, red meat, and full-fat dairy foods. Try replacing red meat with beans, nuts, skinless poultry, and fish whenever possible, and switching from whole milk and other full-fat dairy foods to lower fat versions.

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