Dietetic and educational interventions improve clinical outcomes of diabetic and obese clients with intellectual and/or mental disability

Ms Kerri Hunt2, Dr Kathy Stiller1

Central Adelaide Local Health Network, Adelaide, Australia, 2Supported Residential Facilities Health Access Team, Sefton Park, Australia

 

Aim: While there is evidence to support the effectiveness of dietetic and educational interventions for people with type 2 diabetes or obesity in the general population, their effectiveness in the setting of intellectual or physical disability is unknown. This study evaluated the effect of dietetic and educational interventions provided to clients with type 2 diabetes or obesity characterised by intellectual or physical disability.

Method: A retrospective audit of medical records and databases was undertaken. Clinical outcomes were weight, body mass index and glycosylated haemoglobin (HbA1c) levels.

Results: Ninety-one clients were included (47 with type 2 diabetes, 44 with obesity-only). All but one had schizophrenia, an intellectual disability or other psychological condition. After interventions, the diabetic sub-group demonstrated significant decreases in weight (mean [SD] initial = 101.5 [20.7], final = 97.8 [20.6] kg, P = 0.001) and body mass index (mean [SD] initial = 35.8 [8.1], final = 34.4 [7.8], P = 0.001) and a decrease in HbA1c over time. The obesity-only sub-group showed no significant change in outcomes. Factors that had a significant negative impact on at least one outcome included the presence of schizophrenia (P ≤ 0.017) and refusal of intervention(s) (P ≤ 0.048), whereas a significant positive impact was seen for a greater total number of attendances to a dietitian or diabetes educator (P ≤ 0.024).

Significance of the findings to allied health: The results of this study provide new evidence to support the effectiveness of dietetic and educational interventions for a particularly vulnerable client group.