Cardiovascular disease is the leading cause of death in the world. Type 2 diabetes (T2 D), which exposes people to cardiovascular co-morbidities, continues to progress globally.
Diabetes; Dietary Measures; Hygieno; Lipids
Atherogenic Dyslipidemia is frequently found in subjects with an insulin resistance profile, such as T2 D patients, overweight or obese subjects or with a metabolic syndrome. Various types of strategies are put in place to fight T2 D and its complications; Hygiene and Dietetic Measures (HDM) are part of this program to fight this epidemic. To date, no one is able to know if low carbohydrate diets do not have harmful effects in the long term, as they are often associated with excessive consumption of fat, some of which are known to have an effect. atherogenic.
In this study, we wanted to make an inventory, in the region of Chlef (200 km west of Algiers), on the food mode, therapeutic education and the hygieno-dietetic rules which should accompany any therapeutic scheme. for optimal control of the progression of T2DM [1-4].
Our survey is a descriptive cross-sectional observational study; it took place during the year 2018.
Our work concerned 107 adult T2DM patients of both sexes from 3 municipalities of the Wilaya of Chlef :
- • Inclusion criteria: age> 20 years and <65 years
- • Non-inclusion criteria: pregnancy, child, elderly subjects
- • Exclusion criteria: undernutrition, endocrine pathologies
We were led during the initial consultation and then during the follow-up consultations to collect data relating to:
- • The clinical condition of the patient (anthropometric and bioelectric impedance measurements)
- • Food intake (weekly questionnaire)
- • Hygienic and dietary measures (sedentary lifestyle, physical activity, sleep, smoking, alcoholism)
- • Biological indicators of cardiovascular risk (triglycerides, cholesterol, LDL-C, HDL-C).
The Statistical Package of Social Science (SPSS 17.0) software was used for the statistical study. The statistical significance of the parameters was judged by the Student test.
- • BMI = weight (kg) / height (m2): 31, 25 for the majority of subjects
- • Waist circumference: 0,90 - 1 for more than half of the patients
- • Body composition: on average <20 % lean mass and> 35% fat mass
- • Carbohydrate consumption: high consumption of bread, legumes
- • Lipid consumption: 45 % of daily energy intake
- • Sedentary lifestyle (less than 1 hour of walking per day): majority of patients
- • Carbohydrate balance: glycemia between 1.26 and 2 g / l (52,6 % of subjects) and glycemia> 2g / l for 36,8 % of patients; HbA1C above 7 for more than 50% of patients
Lipid balance: the triglyceride level is close to 2 g / l for 75 % of subjects and> 2 g / l for 25 % of patients, 22 % of the population had a cholesterol level> 2 g / l, more than half of the patients had an LDL-C level> 1,6 g / l and an HDL-C level <0,40 in 20 % of them.
All recommendations recognize that HDM remains one of the fundamental bases for the management of diabetic conditions.
However, it is generally advisable to align drug treatments, dietary measures and lifestyle in especially type 2 diabetes, although the effectiveness of nutritional intervention trials in this area is still more difficult to prove than that of pharmacological studies [5-8].
However, in reality, things are not that simple:
- • Nutrition as a discipline does not always occupy an important place in the medical act;
- • The influx of drugs sometimes makes one lose the sense of the usefulness of an adapted nutritional care;
Finally, nutrition is still often controversial (because nutritional intervention studies are difficult to prove) although the beneficial anti-atherogenic and anti-thrombogenic properties of Monounsaturated Fatty Acids (MUFAs) are proven.
In our study, it turns out that the role of invisible fats in energy supply is unrecognized.
For optimal management of T2 DM, it is recommended:
- • Act on the nature and quantity of carbohydrates and lipids ingested at each meal
- • Increase the fiber content of food
- • Combine other nutrients with dietary carbohydrates