The effect of diet education program on Hemoglobin A1c and interdialytic weight gain in diabetic hemodialysis patient

Abstract

The aim of this study is to analyze whether diet education program could improve blood sugar and interdialytic weight gain in diabetic hemodialysis patient. Total thirty hemodialysis outpatients at an 'C' university hospital in Gyeong gi province enrolled in the study. Fifteen patients who received hemodialysis on Tuesday, Thursday and Saturday were enrolled in the experimental group and the other fifteen patients who received hemodialysis on Monday, Wednesday and Friday were enrolled in the control group. Blood sugar, interdialytic weight gain were collected and analyzed before and after the education program. Data collection and the diet education were performed from May to September 2007. For the experimental group, three sections of the diet education program with the educational materials specially were given. The data were analyzed by x²-test, Fisher's exact test, Mann-Whitney U, Wilcoxon signed rank test and repeated measures ANOVA using SPSS 13.0 for windows and results are as follows. 1. In the experimental group, Hemogloblin A1c levels were significantly decreased from 7.6% to 7.2%(p=.040) after eight weeks of the diet program, whereas those of the control group showed no significant difference. Therefore, hypothesis 1: “the experimental group’s Hemogloblin A1c will be decreased compare with the control group which do not take hemodialysis diet education program.” was supported. 2. Interdialytic weight gain was significantly decreased in both groups(p=.046)(in the experimental group 2.91kg to 2.76kg) but there was no significant difference in weight gain and its tendency between two groups. As a result, hypothesis 2: “ Interdialysis weight gain of the experimental group will be decreased after the diet education program compare with the control group.” was not supported. In conclusion, the study showed that the diabetic hemodialysis diet education program is an effective intervention for decreasing blood sugar. However, further studies for interdialytic weight gain should be conducted to clarify the effect of the diet education program under the control of other weight gain factors.

본 연구는 당뇨병성 혈액투석 식이교육이 혈당과 투석간 체중변화에 미치는 효과를 확인하기 위해 시도된 유사실험 연구이다. 연구대상자는 경기도내 C대학병원 인공신장실에서 정기적으로 혈액투석치료를 받고 있는 환자 30명을 편의추출하여 대상으로 하였다. 화 • 목 • 토요일 투석환자 15명은실험군 으로 월 • 수 • 금요일 투석환자 15명은 대조군으로 선정하여 실험 전 • 후 혈당과 투석간 체중의 변화를 측정하여 비교하였다. 교육 및 자료수집은 2007년 5월부터 9월까지 이루어졌으며 실험군에게는 연구자가 개발한 당뇨병성 혈액투석 식이 교육자료를 이용하여 교육을 제공하였다. 수집된 자료는 SPSS 13.0 for windows를 사용하여 서술통계, x²-test, Fisher's exact test, Mann-Whitney U, Wilcoxon signed rank test, repeated measures ANOVA 등으로 통계 처리하였으며, 그 결과는 다음과 같다. 1. 당뇨병성 혈액투석 식이교육 후 실험군의 당화혈색소(HbA1c)는 교육 전 7.6%에서 교육 8주 후 7.2%로 유의하게 감소하여(p=.040) 가설1 “ 당뇨병성 혈액투석 식이교육을 받은 실험군이 교육을 받지 않은 대조군보다 당화혈색소의 수치가 낮아질 것이다.”는 지지되었다. 2. 당뇨병성 혈액투석 식이교육 후 실험군의 투석 간 체중증가는 교육 전 2.91kg에서 교육 8주 후 2.76kg로 나타나(p=.409) 가설2 “당뇨병성 혈액투석 식이교육을 받은 실험군이 교육을 받지 않은 대조군보다 투석 간 체중 증가 정도가 적을 것이다.”는 지지되지 않았다. 이상의 결과로 당뇨병성 혈액투석 식이교육이 혈당의 실제적인 감소 및 안정에 효과적인 중재임을 알 수 있었다. 그러나 투석 간 체중증가는 다른 체중증가 요인을 통제한 후 효과를 재검증할 필요가 있다.