Khanna Raman, Stoddard Pamela J, Gonzales Elizabeth N, Villagran-Flores Mariana, Thomson Joan, Bayard Paul, Palos Lucio Ana Gabriela, Schillinger Dean, Bertozzi Stefano, Gonzales Ralph
Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA
Santa Clara County Public Health Department, San Jose, CA, USA.
J Diabetes Sci Technol. 2014 Nov;8(6):1115-20. doi: 10.1177/1932296814550186. Epub 2014 Sep 19.
In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (-0.3% in the control arm, -0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland.
在美国，讲西班牙语的糖尿病患者常常得不到充分的饮食咨询。持续提供符合语言和文化的饮食咨询对糖尿病自我护理至关重要。为了确定自动化电话营养支持（ATNS）咨询能否通过在加利福尼亚州奥克兰市讲西班牙语的人群中复制在墨西哥的一项成功试点，来帮助患者改善血糖控制。进行了一项带有盲法终点评估的前瞻性随机开放标签试验（PROBE）。参与者是七十五名在加利福尼亚州奥克兰市一家联邦合格健康中心接受治疗的成年糖尿病患者。ATNS是一个通过电话拨打患者的计算机系统，用西班牙语提示他们（通过键盘）输入前24小时内所食用的各种特定文化饮食项目的分量，然后根据所摄入的高血糖指数食物与低血糖指数食物的比例提供饮食反馈。对照组在入组14周后接到相同的ATNS电话。主要结局是入组12周后的糖化血红蛋白百分比（A1c）。参与者的A1c没有显著改善（对照组降低0.3%，干预组降低0.1%，任何差异的P值为0.41），也没有任何次要参数得到改善。在我们的研究中，ATNS系统未能改善加利福尼亚州奥克兰市讲西班牙语人群的糖尿病控制情况。
