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SUNDAY, NOVEMBER 7

POSTER SESSION: PROFESSIONAL SKILLS; NUTRITION ASSESSMENT; MEDICAL NUTRITION THERAPY

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mpact of Demographic and Psychosocial Variables onetabolic Control of Low Income Type 2 Diabetes Mellitusatients in Mexico City

uthor(s): G. Levin Pick, V. Mota Sanhua, L. Rivas Ayala,. Rojas Jimenez; Clınica de Diabetes, Clınica ABC Amistad, Centroedico ABC, Mexico City, Mexico

earning Outcome: To identify the effect of demographic andsychosocial variables on the metabolic control of low-income type 2iabetes mellitus patients at a primary care clinic in Mexico City.

n Mexico, type 2 diabetes mellitus (T2DM) is a major public healthoncern. The aim of this study was to evaluate the impact ofemographic and psychosocial variables on metabolic control (MC) of2DM patients. In 2009, a cross-sectional study was conducted in 502DM low-income adult patients attending a primary care clinic inexico City. The study variables included: sex, age, marital status,

ducational level, time since T2DM diagnosis, depression, socialupport (SS) and MC. Depression was measured with the Beckepression Inventory. SS was measured using a validated DiabetesS Questionnaire. MC was analyzed as a quantitative variableombing three metabolic outcomes; patients with lower MC presentedetabolic syndrome (MetS) according to NECP-ATPIII criteria,bA1c �7% and overweight/obesity. Frequencies and proportions andedia and S.D. were calculated for qualitative and quantitative

ariables, respectively. Multiple regression analysis was used tovaluate the effect of the study variables on the level of MC. Theean age of the study population was 54.5 (�11.5); 64% were female.he majority were married or partnered (76%) and 82% referredrimary education. The prevalence of depression was 34%. SS waserceived in 60% of all patients. The prevalence of MetS, alteredbA1c and overweight/obesity was of 54%, 82% and 46%,

espectively. Male patients (Beta:-1.498, IC 95%:-2.649- -0.348) andower educational level (Beta:-1.769, IC 95%:-3.237- -0.301) weressociated to a worse MC. Understanding the association ofemographic and psychosocial factors on the control of the disease ispriority for the design of DM2 interventions.

unding Disclosure: Self-funded

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utcomes from A Creative Approach to Diabetes Education--Motivatingexans to Do Well with Diabetes Control via Cooking Well Schools

uthor(s): M. C. K. Bielamowicz,1 P. Pope,2 C. A. Rice3; 1Texas AgriLifextension Service, Department of Nutrition & Food Science, Texas A&Mniversity, College Station, TX, 2Organizational Development, Texas AgriLifextension Service, Texas A&M University, College Station, TX, 3Familyevelopment and Resource Management, Texas AgriLife Extension Service,exas A&M University, College Station, TX

earning Outcome: Diabetic participants improve blood glucose controlhrough nutrition/self-care knowledge, skills, healthy food preparation practicesnd creative teaching techniques that help motivate clients to change.

ype 2 diabetes—a rising health problem in Texas—affects some 2.1 millionexans (1.8 million diagnosed) costing individuals, employers, the health careystem, and the State more than $12.5 billion yearly. Diabetic individuals cananage their blood glucose levels and reduce their risk of complications by

racticing learned nutrition/self-care skills. Do Well, Be Well with Diabetesurriculum (nine nutrition/self-care lessons) was created/pilot-tested by TexasgriLife Extension Service. Since 2003, 172 trained County Extension Agents -amily/Consumer Sciences provided leadership for local health coalitions

nurses, dietitians, diabetes educators, physicians, pharmacists, podiatrists, etc.)o plan, implement and evaluate this diabetes management program with thestimated potential lifetime health care cost savings of 81 million dollars. Doell, Be Well with Diabetes, Phase 2., is the pilot-tested, 4-lesson Cooking Wellith Diabetes curriculum offered to diabetic individuals who completed the self-

are/nutrition diabetes program to motivate them to continue practicing learnedutrition/self-care skills for better blood glucose control. Educators’ methodemonstrations performed with showmanship included diabetes/nutrition/foodafety tips. Participants learned to prepare Texas-styled foods with ethnicariations to: add more fiber; reduce fat, sugar and sodium; and control portionsith the plate method. On-line data collection (pre-, post- and post-post-surveys)ocumented outcomes. Trained agents in 74 counties conducted cooking schoolsor 2,230 diabetic individuals completing the pre-surveys with useable data setsn�1,004). Results showed changes in food preparation practices plus a modestncrease in knowledge. Barriers to physician-prescribed diabetes meal plansere identified. Opportunities exist for dietitians/educators to develop

nnovative ways to overcome these barriers.

unding Disclosure: Texas AgriLife Extension Service, Texas A&M Universityystem

-42 / September 2010 Suppl 2—Abstracts Volume 110 Number 9

mpact of Hospital Room Service Meals on Glycemic Controln Patients with Diabetes

uthor(s): A. Canning,1 A. Nickerson,1 C. McIsaac2; 1Nutrition andood Sciences, University of Vermont, Burlington, VT, 2Nutritionervices, Fletcher Allen Health Care, Burlington, VT

earning Outcome: To determine whether hospital room service“meals on demand”) improves glycemic control in patients withiabetes versus the traditional tray service (paper menus completedne day prior to meals).

ackground: Diabetes management among hospitalized patientsresents many challenges. Poor glycemic control in a hospital settingay result in severe adverse consequences, such as delayed wound

ealing, increased infection rates, and mortality. This pilot study wasonducted to determine whether room service (patient selects foods/eals just prior to eating, “meals on demand”) improves glycemic

ontrol in patients with diabetes versus the traditional tray servicepaper menus completed one day prior to meals).

ethods: Medical records of 80 patients with diabetes were reviewednd the following data were collected: age, gender, height, weight,dmitting diagnosis, diet prescription while hospitalized, type of mealervice patient used, insulin prescribed during hospital stay, numberf days hospitalized, number of days patient was prescribed a diet,ny steroids prescribed, and finger stick blood glucose values. Datarom patients hospitalized prior to the introduction of room serviceere collected from a data warehouse and compared to data fromatients hospitalized within a three-month period after room serviceegan. Finger stick blood glucose values were compared using annalysis of co-variance. Other data categories were analyzed toetermine their effect on blood glucose values and to produceemographic information.

esults/Conclusion: Data collection is incomplete at this time; finalesults and conclusions will be reported at FNCE.

unding Disclosure: None

nowledge, Attitudes, and Beliefs of Certified Diabetesducators about their Diabetes Self-Management Education

DSME) Programs

uthor(s): D. S. Pothier,1 A. Nickerson,1 R. Edelman2; 1University ofermont, Burlington, VT, 2Vermont Department of Health,urlington, VT

earning Outcome: Attendees will gain knowledge regardingiabetes educators’ perceived strengths and challenges of self-anagement education programs.

he Diabetes Self-Management Education (DSME) programs offeredn Vermont are diverse, not evidence-based and have displeasingttributes according to the certified diabetes educators (CDE) whodminister them. The objective for this study was to survey CDEsesponsible for administering the DSME programs statewideoncerning their level of satisfaction or dissatisfaction withomponents of their DSME program, and to inquire about theirwareness of and inform them about other Stanford University self-anagement programs recently introduced in Vermont. Fifteen CDEsere directed to a brief online survey and were then asked for

onsent to a more in-depth, semi-structured phone interview. Aualitative analysis was conducted to examine level of satisfactionith components of their program, barriers to attendance andttitudes about other existing self-management programs inermont. Fourteen of the 15 CDEs contacted completed the onlineurvey, and 12 of 14 consented to the phone interview. Results fromhis study revealed that most CDEs were dissatisfied with programttendance, provider referrals, and reimbursement. Patient barrierso attendance, as identified by CDEs, include lack of transportation,xpense, and a perception that consumers do not think DSME is anmportant part of their diabetes care. All CDEs were familiar withhe Stanford Chronic Disease Self-Management Program offeredtatewide with only seven of 12 CDEs having heard about Stanford’sewer Diabetes Self-Management Program. CDE’s fear that the

atter will provide competition with their current DSME programs.

unding Disclosure: None