Diabetic Patients' Nutrition status in Clinic

1. Nutrition Status of DM Patients
in Medicine clinic-PMBAH
Presenter
Dr. Atta ur Rehman Khan, Clinical Dietitian
Clinical Nutrition Department, Prince Muhammad Bin Abdulaziz Hospital, Ministry of
National Guard Health Affairs, Al Medina Munawarrah

2. Nutrition Status of DM Patients
in Medicine clinic-PMBAH
Principal Investigator: Dr. Atta ur Rehman
Co-Investigators: Dr.Ijaz Abid,Ms.Nur Adila, Ms.Nora Al Jayyar

3. Conflict of Interest
 Authors report no conflict of interest for this study.

4. Objective
 To study the prevalence of
overweight/obesity in
medical out Patients with
Diabetes Mellitus Type-II.
 To study association
between Hyperglycemia and
associated dietary risk
factors

5. Methodology
Study setting:
Internal Medicine Clinic -Outpatients, PMBAH
Data Collection:
Clinical Nutrition Department
Out Patient Medicine department

6. Methodology
 Study Design:
-Cross-sectional Study.
 Sample Size:
-Eighty four (84) Patients with Diabetes Mellitus Type II.
 Inclusion Criteria:
-All male and female Patients with DMT2
-Age between 20 – 70 years.
 Exclusion Criteria:
-Bed ridden, Pregnant women and terminally ill patients.
 A pre-structured Questionnaire :
-Demographics and Dietary Intake Data, Anthropometric

7. Results

8. Patients’ Physical/Clinical Characteristics
Variables Overall Male Female
Weight
Height
BMI
Waist
WHR
Blood Glucose (R)
Blood Pressure
-Systolic
-Diastolic
Mean ±SD
82 19.54
157 9.10
32.9 8.30
102 23.90
0.93 0.13
10.5 3.84
135 20.96
66 9.38
Mean ±SD
86 23.35
166 6.16
31.3 7.57
109 17.09
1.00 0.10
11.02 5.01
138 24.46
65 7.78
Mean ±SD
79.8 17.07
152 6.67
33.69 8.74
99.71 26.16
0.89 0.13
10.06 2.55
133 18.32
67 10.38

9. Nutritional status (NS) Numbers (N) Percentage (%)
Malnourished 3 4%
Normal 8 10 %
Overweight 19 24%
Obese (grade- I) 17 21 %
Moderately Obese (grade- II) 18 23 %
Morbidly Obese (grade- III) 15 19 %
Overall Nutritional Status

10. Nutritional Status by Gender
Nutritional status (NS) Male
Numbers (N) Percentage
(%)
Female
Numbers (N) Percentage
(%)
Malnourished 1 4 2 4
Normal 3 11 5 9
Overweight 9
33
10 19
Obese (grade- I) 8
30
9 17
Moderately Obese (grade- II) 3
11
15 28
Morbidly Obese (grade -III) 3
11
12 23

11. Nutrition Status based on Body
Mass Index (BMI)
 High prevalence of obesity was found in this study similar to other
epidemiological studies in kingdom (1-3).
 Two third 2/3 of the patients were obese. In addition, ¼th who were
overweight were excluded from this number. If we combine all
overweight and obese, the figure will rise up to the dangerous levels of
87%.
 This is unprecedented level of increased weight issue. Moreover,
Overweight and obesity was not significantly different when bivariate
analysis of socioeconomic variables was done. Only marital status was
an exception where significant difference was proven (P-value < 0.006).
 1.Al Othaimeen AI, Al Nozha M, Osman AK (2007) . 2.Ahmed HG et al (2014). 3. Khan F., 2014.

12. Dairy and Fruits/Vegetables –
BMI and Hb A1C
Our study suggests that including milk, grains, fruits
and vegetables and vegetable based nutrients will be
of great significance to these patients as we found
strong correlation. The correlation was negative (p-value
<0.001).

13. Activity Level –Overall
Variable Overall
Activity level
(n = 83)
Low Normal Active
(%)
54
(%)
43
(%)
2

14. Activity Level by Gender
Variable Male Female
Activity level
(n = 83)
Low Normal Active Low Normal Active
(%) (n)
32 9
(%) (n)
64 18
(%) (n)
1 1
(%) (n)
65 36
(%) (n)
33 18
(%) (n)
2 1

15. Physical Activity- BMI and HbA1C
 Lack of Physical activity was contributed towards higher BMI and
ultimately poor glycemic control during the course of treatment.
 Our results revealed a significant difference of BMI with different level
of physical activity (P –value <0.022). BMI reduced when there was good
amount of physical activity.
 This result is similar to other studies which called for empowerment of
patients to self-manage their disease by lifestyle changes.

16. Conclusions:
 Nutrition status is consistently associated with DM treatment
outcomes
 The prevalence of Obesity and over weight is high in DM
patients.
 Formation of Multidisciplinary teams in Clinics with necessary
presence of Dietitian.
 Launch a data base for all diabetic patients to record all
information on their lifestyle, dietary behaviors and pre and
post treatment changes.
 Mass Nutritional awareness programs
 Physical Activity awareness programs

17. Thank you