Effect of Nutrition Education Groups in the Treatment of Patients with Type 2 Diabetes

The Glycated Hemoglobin test (high precision chromatography on a Merck-Hitachi 9100 device with reference values of 4.8-6.0%) will be performed at the Clinical Pathology Laboratory of the Hospital de Clínicas de Porto Alegre (HCPA) by means of blood sample. The patient will be instructed to fast for 12 hours.

The Glycated Hemoglobin test (high precision chromatography on a Merck-Hitachi 9100 device with reference values of 4.8-6.0%) will be performed at the Clinical Pathology Laboratory of the Hospital de Clínicas de Porto Alegre (HCPA) by means of blood sample. The patient will be instructed to fast for 12 hours.

The Glycated Hemoglobin test (high precision chromatography on a Merck-Hitachi 9100 device with reference values of 4.8-6.0%) will be performed at the Clinical Pathology Laboratory of the Hospital de Clínicas de Porto Alegre (HCPA) by means of blood sample. The patient will be instructed to fast for 12 hours.

Diabetes kidney disease and diabetic retinopathy will be collected from patients' electronic medical records at baseline and at the end of the study (12 months).

Anthropometric measurements will be used to assess nutritional status and will include weight (with light clothes and without shoes) and height. For such measurements, an anthropometric scale and a fixed wall stadiometer will be used. BMI will be calculated from the formula weight (kg)/height2) and will be considered healthy weight (therapeutic target) when <25 kg/m2 for adults and <27 kg/m2 for the elderly.

Anthropometric measurements will be used to assess nutritional status and will include weight (with light clothes and without shoes) and height. For such measurements, an anthropometric scale and a fixed wall stadiometer will be used. BMI will be calculated from the formula weight (kg)/height2) and will be considered healthy weight (therapeutic target) when <25 kg/m2 for adults and <27 kg/m2 for the elderly.

Anthropometric measurements will be used to assess nutritional status and will include weight (with light clothes and without shoes) and height. For such measurements, an anthropometric scale and a fixed wall stadiometer will be used. BMI will be calculated from the formula weight (kg)/height2) and will be considered healthy weight (therapeutic target) when <25 kg/m2 for adults and <27 kg/m2 for the elderly.

The analyzes will be carried out at the Clinical Pathology Laboratory of the Hospital de Clínicas de Porto Alegre and will comprise: fasting plasma glucose (measured by the enzymatic glucose-peroxidase method - Biodiagnostic Kit), total cholesterol (colorimetric enzymatic method), HDL cholesterol (colorimetric reaction enzyme analysis, methods described by Farish and modified Fletcher) and serum triglycerides (colorimetric enzymatic method using a commercial kit, as described by McGowan). LDL cholesterol will be calculated using the Friedewald formula for patients with serum triglycerides below 400 mg/dL. The patient will be instructed to fast for 12 hours. Fasting glucose values between 80 - 130 mg/dL, HbA1c <7%, LDL-cholesterol <100 mg/dL and triglycerides <150 mg/dL will be considered within the recommended therapeutic target. Patients with HbA1c <7.0% (adults) and <7.5% (elderly) will be considered with good glycemic control.

The analyzes will be carried out at the Clinical Pathology Laboratory of the Hospital de Clínicas de Porto Alegre and will comprise: fasting plasma glucose (measured by the enzymatic glucose-peroxidase method - Biodiagnostic Kit), total cholesterol (colorimetric enzymatic method), HDL cholesterol (colorimetric reaction enzyme analysis, methods described by Farish and modified Fletcher) and serum triglycerides (colorimetric enzymatic method using a commercial kit, as described by McGowan). LDL cholesterol will be calculated using the Friedewald formula for patients with serum triglycerides below 400 mg/dL. The patient will be instructed to fast for 12 hours. Fasting glucose values between 80 - 130 mg/dL, HbA1c <7%, LDL-cholesterol <100 mg/dL and triglycerides <150 mg/dL will be considered within the recommended therapeutic target. Patients with HbA1c <7.0% (adults) and <7.5% (elderly) will be considered with good glycemic control.

The analyzes will be carried out at the Clinical Pathology Laboratory of the Hospital de Clínicas de Porto Alegre and will comprise: fasting plasma glucose (measured by the enzymatic glucose-peroxidase method - Biodiagnostic Kit), total cholesterol (colorimetric enzymatic method), HDL cholesterol (colorimetric reaction enzyme analysis, methods described by Farish and modified Fletcher) and serum triglycerides (colorimetric enzymatic method using a commercial kit, as described by McGowan). LDL cholesterol will be calculated using the Friedewald formula for patients with serum triglycerides below 400 mg/dL. The patient will be instructed to fast for 12 hours. Fasting glucose values between 80 - 130 mg/dL, HbA1c <7%, LDL-cholesterol <100 mg/dL and triglycerides <150 mg/dL will be considered within the recommended therapeutic target. Patients with HbA1c <7.0% (adults) and <7.5% (elderly) will be considered with good glycemic control.

Three blood pressure measurements will be performed with a Digital Blood Pressure Monitor Omron sphygmomanometer model HEM-705CP, with an interval of one minute, with the patient sitting down after five minutes of rest, using a cuff of the appropriate size for the arm diameter.

Three blood pressure measurements will be performed with a Digital Blood Pressure Monitor Omron sphygmomanometer model HEM-705CP, with an interval of one minute, with the patient sitting down after five minutes of rest, using a cuff of the appropriate size for the arm diameter.

Three blood pressure measurements will be performed with a Digital Blood Pressure Monitor Omron sphygmomanometer model HEM-705CP, with an interval of one minute, with the patient sitting down after five minutes of rest, using a cuff of the appropriate size for the arm diameter.

Eating behavior will be evaluated using the Intuitive Eating Scale-2 (IES-2), adapted to Portuguese. This scale, based on principles of intuitive eating, encompasses questions about food attitudes and has been designed to assess adherence to hunger and satiety signals. Food consumption will be estimated through the 24-hour dietary recalls Multiple-Pass Method. Additionally, the study will assess the frequency of consumption of sweets, sugary drinks, alcoholic beverages, fried foods, cooking oil, and added oil after preparation (specifying type and quantity per capita), as well as sausages, canned goods, preserves, industrialized seasonings, meat, and eggs.

Eating behavior will be evaluated using the Intuitive Eating Scale-2 (IES-2), adapted to Portuguese. This scale, based on principles of intuitive eating, encompasses questions about food attitudes and has been designed to assess adherence to hunger and satiety signals. Food consumption will be estimated through the 24-hour dietary recalls Multiple-Pass Method. Additionally, the study will assess the frequency of consumption of sweets, sugary drinks, alcoholic beverages, fried foods, cooking oil, and added oil after preparation (specifying type and quantity per capita), as well as sausages, canned goods, preserves, industrialized seasonings, meat, and eggs.

Eating behavior will be evaluated using the Intuitive Eating Scale-2 (IES-2), adapted to Portuguese. This scale, based on principles of intuitive eating, encompasses questions about food attitudes and has been designed to assess adherence to hunger and satiety signals. Food consumption will be estimated through the 24-hour dietary recalls Multiple-Pass Method. Additionally, the study will assess the frequency of consumption of sweets, sugary drinks, alcoholic beverages, fried foods, cooking oil, and added oil after preparation (specifying type and quantity per capita), as well as sausages, canned goods, preserves, industrialized seasonings, meat, and eggs.

The SARC-F questionnaire (a simple tool for rapid sarcopenia diagnosis) will be administered by phone. Calf circumference will be measured at the point of greatest horizontal circumference, with the subject sitting, legs in a non-contracted position, and 20 cm apart. Handgrip strength will be assessed using a Hydraulic Hand Dynamometer (in the dominant hand), and the walking test will involve the patient walking a pre-marked distance of four meters (measured with the aid of a stopwatch). The cutoff points employed to identify low muscle strength will be <26 kg for men and <16 kg for women, with altered waist circumference defined as >102 for men and >88 for women. For dynapenic abdominal obesity, individuals with both low muscle strength and altered waist circumference will be considered.

The SARC-F questionnaire (a simple tool for rapid sarcopenia diagnosis) will be administered by phone. Calf circumference will be measured at the point of greatest horizontal circumference, with the subject sitting, legs in a non-contracted position, and 20 cm apart. Handgrip strength will be assessed using a Hydraulic Hand Dynamometer (in the dominant hand), and the walking test will involve the patient walking a pre-marked distance of four meters (measured with the aid of a stopwatch). The cutoff points employed to identify low muscle strength will be <26 kg for men and <16 kg for women, with altered waist circumference defined as >102 for men and >88 for women. For dynapenic abdominal obesity, individuals with both low muscle strength and altered waist circumference will be considered.

The SARC-F questionnaire (a simple tool for rapid sarcopenia diagnosis) will be administered by phone. Calf circumference will be measured at the point of greatest horizontal circumference, with the subject sitting, legs in a non-contracted position, and 20 cm apart. Handgrip strength will be assessed using a Hydraulic Hand Dynamometer (in the dominant hand), and the walking test will involve the patient walking a pre-marked distance of four meters (measured with the aid of a stopwatch). The cutoff points employed to identify low muscle strength will be <26 kg for men and <16 kg for women, with altered waist circumference defined as >102 for men and >88 for women. For dynapenic abdominal obesity, individuals with both low muscle strength and altered waist circumference will be considered.

We will assess adherence to the nutritional combinations during each scheduled visit (at four, eight, and 12 months), as well as adherence to the Diabetes Plate Method. Additionally, the attendance of participants randomized to the intervention group will be monitored through their presence at the scheduled meetings, considering patients who attend at least two meetings. In the control group, assiduity will be evaluated based on return consultation attendance.

We will assess adherence to the nutritional combinations during each scheduled visit (at four, eight, and 12 months), as well as adherence to the Diabetes Plate Method. Additionally, the attendance of participants randomized to the intervention group will be monitored through their presence at the scheduled meetings, considering patients who attend at least two meetings. In the control group, assiduity will be evaluated based on return consultation attendance.

We will assess adherence to the nutritional combinations during each scheduled visit (at four, eight, and 12 months), as well as adherence to the Diabetes Plate Method. Additionally, the attendance of participants randomized to the intervention group will be monitored through their presence at the scheduled meetings, considering patients who attend at least two meetings. In the control group, assiduity will be evaluated based on return consultation attendance.