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Aims/IntroductionWe devised a new system called “Educational Guidance” (E‐Guide) for nutritional education based on self‐efficacy. The present study aimed to examine the effects of E‐Guide use on glycemic control among patients with type 2 diabetes.Materials and MethodsWe carried out an interventional and observational study that included 74 patients with type 2 diabetes. The extent of glycemic control in the 39 patients who received guidance through the E‐Guide (E‐Guide group) was compared with that of 35 patients who received conventional nutritional guidance (control group). We carried out a 1‐year follow‐up survey (subanalysis) based on the electronic health records of 18 patients from the E‐guide group and 19 patients from the control group. These patients continued treatment at Hikone Municipal Hospital, Hikone, Shiga, Japan. Changes in glycated hemoglobin levels, body mass index and medication dose were examined from time of enrollment to the end of the 1‐year intervention, and during the 1‐year follow‐up.ResultsDecreases in glycated hemoglobin levels were more pronounced in the E‐Guide group than in the control group during the intervention period (P < 0.05). The levels further decreased during the follow‐up period (P < 0.01). In the E‐Guide group, body mass index decreased significantly throughout the follow‐up period (P < 0.001). Additionally, increased medication doses were significantly less common in the E‐Guide group than in the control group (P < 0.01).ConclusionsIntervention based on our “E‐Guide” is more useful and powerful than the conventional methods for glycemic control and self‐care behavior among patients with type 2 diabetes in Japan.

The aim of this study was to investigate the effects of increased dietary protein in daily-life settings in Japan for 6 months on the activities of daily living (ADL) in adults aged 75 or older at nutritional risk. The study was an open-label, exploratory, randomized controlled trial conducted at seven hospitals in Japan. The study participants were adults aged 75 or older who were hospitalized for treatable cancer, pneumonia, fractures, and/or urinary-tract infection at nutritional risk. The primary outcome was change in grip strength, skeletal muscle, and ADL indices (Barthel index, Lawton score). One hundred sixty-nine patients were randomly assigned to the intensive care (IC) or standard care (SC) group; the protein intake goals (g/kgw/day) were 1.5 for IC and 1.0 for SC. There was a significant improvement in grip strength only in the IC group (1.1 kg: 95% CI 0.1 to 2.1) (p = 0.02). While the skeletal muscle index and ADL indices were not significantly improved in either group, the improvement ratio tended to be greater in the IC group. There was no decrease in renal function in either group. Thus, intervention of increased dietary protein in daily-life settings for 6 months in adults aged 75 or older with treatable cancer, pneumonia, fractures, and/or urinary-tract infection and at nutritional risk may be effective in ameliorating loss of muscle strength.

The aim of this study was to examine the association between serum reproductive hormone concentrations, dietary intakes and skeletal muscle mass in patients with type 2 diabetes. This cross-sectional study investigated 54 Japanese patients with type 2 diabetes (32 males) during the period between 2014 to 2018. All patients completed measurements of serum dehydroepiandrosterone sulfate concentration (DHEA-S), skeletal muscle index (SMI) and dietary intakes at same period. Those who had adrenal tumor, thyroid cancer, and thyroid dysfunction were excluded. In the analysis, as a first-step, we conducted single regression analysis between age, DHEA-S, SMI, total energy and each macronutrient intakes. SMI was positively correlated with total energy and protein intakes. Interestingly, while protein intakes derived from animal foods were positively correlated with SMI, those from plant foods showed negative correlation. On the other hand, DHEA-S was positively correlated with SMI. Then, multiple regression analysis (MRS) was performed to examine the contributors to SMI (Table). MRS revealed the association of SMI with DHEA-S and protein intakes. Our data suggest that DHEA-S and protein intakes are the factors contribute to SMI in Japanese patients with type 2 diabetes. Disclosure S. Moyama: None. H. Kuwata: Research Support; Self; Eli Lilly and Company. Y. Hamamoto: Speaker's Bureau; Self; Novo Nordisk A/S. D. Yabe: Advisory Panel; Self; Abbott. Research Support; Self; Astellas Pharma Inc. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. Y. Seino: Research Support; Self; Arkray, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation.