Theses and Desertations

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Browsing Theses and Desertations by Author "ADEYEMI, YETUNDE ADERONKE"

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    DIETARY SUPPLEMENTATION AND COUNSELLING INTERVENTIONS ON INSULIN RESISTANCE, TRACE ELEMENTS AND ANTIOXIDANT VITAMINS LEVELS IN TYPE 2 DIABETIC SUBJECTS IN OGUN STATE NIGERIA
    (2023-10-30) ADEYEMI, YETUNDE ADERONKE
    ABSTRACT Type 2 diabetes mellitus (T2DM) is one of the most widespread endocrinological diseases in the general population and especially among hospitalized subjects. Studies have shown that diabetic subjects have micronutrient deficiencies. Hence, the need for dietary supplementation and counselling interventions to address the deficiency of serum trace elements and Vit C and E deficiencies. This study investigated the effects of dietary supplementation and counselling interventions on insulin resistance, trace elements and antioxidant vitamins levels in T2DM subjects. The study utilised randomised controlled trials design with pre-test and post-test assessments. Baseline, intervention period and end point data collection on 134 T2DM subjects and 130 apparently healthy adults (not diagnosed with T2DM was carried out at the Endocrinology department of Federal Medical Centre, Abeokuta, Nigeria. A semi-structured interviewer administered questionnaire was used to obtain information on socio-demographic characteristics of the subjects. Dietary intake was assessed using multi-pass 24-hour dietary recall and analysed to determine energy and nutrients intake. Anthropometric measurements (weight, height, hip and waist circumference) were obtained using standard procedures. Body Mass Index (BMI) and Waist-Hip ratio were calculated from the measurements using WHO standards. Biochemical parameters at both baseline and intervention (insulin secretion level, insulin resistance, serum trace elements, vitamins E and C) was analysed using standard laboratory procedures. T2DM subjects were randomized into two groups (Dietary Counselling Group (DCG (n=67)) and Dietary Supplementation Group (DSG (n=67)). Eight weeks administration of minerals and vitamins were given to DSG, while dietary counselling was done for those in DCG. Data were analyzed using frequency counts, percentages, mean standard deviation, Analysis of variance and multiple regression. At baseline, the results showed that 60.4% had tertiary education, 47.0% earned above seventy thousand naira/month and 37.3% were retired. There was significant difference between the mean BMI of cases (26.93±6.43) and control (24.37±6.053) (p=0.001). Dietary intake showed that 75.0% and 84.5% of the T2DM subjects and non-T2DM subjects met less than 100.0% Recommended Dietary Allowance (RDA) for energy, carbohydrates, protein, and fat respectively. The mean plasma levels of glucose, insulin secretion levels, insulin resistance levels, vitamin C and vitamin E of T2DM subjects were significantly higher (p<0.05) compared to that of non-T2DM subjects. The mean serum levels of trace elements of T2DM subjects were significantly lower (p< 0.05) to that of non-T2DM subjects. There was a significantly (p =0.005) higher serum Cu level in T2DM subjects (144.77±14.32 µg/dl) than in the non-T2DM subjects (119.95±38.78 µg/dl). At intervention phase, there was significant (p< 0.05) reduction in mean plasma fasting glucose, insulin secretion levels, vitamin C and vitamin E in the DSG and DCG as compared to their baseline values of T2DM and non-T2DM subjects. In conclusion, there was a significant (p<0.005) reduction in serum trace elements and plasma levels of antioxidants, vitamins E and C, among T2DM subjects as compared to non-T2DM subjects. Eight weeks supplementation of minerals and vitamins, with individualized dietary counselling were found to have significantly decreased (p< 0.05) plasma fasting blood glucose levels, and insulin resistance levels in T2DM subjects.