Relationship between the ability to recognize energy intake and expenditure, and blood sugar control in type 2 diabetes mellitus patients

To investigate the association between an individual's ability to recognize his/her energy intake and energy expenditure with the status of diabetes mellitus (DM) control, we conducted a cross-sectional study using data from 62 outpatients with type 2 DM (46 men and 16 women), aged 33-77 years, from two hospitals in Tokyo in 1999. A dietitian-interviewer asked the patients to estimate their probable energy intake and expenditure in recent days (self-estimated energy intake and expenditure, respectively). Subsequently, a dietary survey was conducted to estimate the patient's energy intake by a self-recorded method with a dietitian's interview for three continuous business days; the physical exercise levels were measured using a pedometer with multiple-memory accelerometers for one week. The percentage of subjects whose self-estimated energy intake was within ±10% of the dietary survey-based energy intake became significantly lower as the control status worsened (35.6, 12.9, and 11.1% in the first, second, and third tertile groups of HbA1c, respectively; P = 0.015). Similar but non-significant results were observed for the energy expenditure (P = 0.35). Since the control status of DM was worse among patients who could not recognize their amount of caloric intake and expenditure, a training program to improve such recognition ability may be needed.