Effects of the PRo-active Interdisciplinary Self-MAnagement (PRISMA, Dutch DESMOND) program on dietary intake in type 2 diabetes outpatients: a pilot study

Abstract

Background & aims: To investigate the effect on dietary intake of the PRo-active Interdisciplinary Self-MAnagement (PRISMA) program, developed analogous to DESMOND, in overweight type 2 diabetes patients.

Methods: All type 2 diabetes patients referred to the Diabetes Outpatient Clinic of the VU University Medical Center Amsterdam with a BMI >25kg/m(2), were eligible for inclusion to the PRISMA program. At baseline and after 3, 6 and 12 months of follow-up, macronutrient intake, anthropometric, biomedical and psychosocial measures were evaluated by using Generalized Estimation Equations.

Results: Included into the study were 38 patients, of which 22 completed a 1-year follow-up. After 6 months energy and macronutrient intake were significantly decreased. Reductions after 12 months were still significant for protein, unsaturated fat and dietary fiber and borderline significant for energy and saturated fat intake. Patients positively evaluated the program, and most patients held the view that they had learned something from PRISMA.

Conclusions: The PRISMA program reduced energy and macronutrient intake up to 6 months. After 6 months, attention should be paid to patients' food product choices. Follow-up counselling might further improve long-term outcome. This pilot study shows that the PRISMA program is promising in decreasing dietary intake in newly diagnosed and established overweight type 2 diabetes patients in secondary care.