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Effects of Carbohydrate Reduction Program and Telemonitoring on Glycosylated Hemoglobin in Patients with Poorly Controlled Type 2 Diabetes: A Randomized Controlled Trial

Jantraporn R, MNS¹, Pichayapinyo P, PhD¹, Lagampan S, EdD¹, Mayurasakorn K, MD, FRCFPT²

Affiliation : ¹ Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Bangkok, Thailand ² Department of Health Research and Development, Siriraj Medical Research Center, Mahidol University, Bangkok, Thailand


Objective: To examine whether a carbohydrate reduction program combined with telemonitoring improves glycosylated hemoglobin (HbA1c) in patients with poorly controlled type 2 diabetes.
Materials and Methods: A randomized controlled trial with two-group pretest-posttest design and follow-up was conducted in the Primary Care Unit at Siriraj Hospital, Bangkok, Thailand. Fifty-three patients with poorly controlled type 2 diabetes aged from 35 to 59 years were randomly assigned to two groups, an experimental group (n = 26) that received both routine care and a dietary carbohydrate program applying telephone monitoring, and a comparison group (n = 27) that received only routine care. HbA1c was assessed at baseline and at 12 weeks. Dietary self-efficacy and consumption behavior were measured at baseline, 8 weeks, and 12 weeks.
Results: According to the findings, the HbA1c levels in the experimental group at 12 weeks showed significant improvement compared to baseline and the comparison group (p<0.05). The mean difference in dietary self-efficacy and consumption behavior at 12-week were significantly higher than baseline and greater than those in the comparison group (p<0.05).
Conclusion: The study program was effective in decreasing HbA1c levels because the program enhanced patients’ confidence in dietary control, which improved consumption behavior.

Keywords : Carbohydrates, Telemonitoring, Type 2 diabetes, Glycosylated hemoglobin


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