Association between Macronutrient Intake Pattern, Glycemic Status and Use of Antidiabetic Drugs among Type 2 Diabetes Patients
Keywords:Type 2 Diabetes Mellitus (T2DM), Oral Anti-Diabetic drugs (OADs), carbohydrate, protein, fat, glycemic control
AbstractThe study was aimed to assess the macronutrient intake pattern and its association to glycemic status and drug intake pattern of type 2 diabetes patients. Forty five subjects (25 males and 20 females) aged between 30 and 60 years, diagnosed with diabetes for less than 3 years were enrolled into the study. Based on Oral Anti-Diabetic drugs (OAD) treatment, they were grouped as those on mono-therapy (GpI, n=21) and dual therapy (GpII, n=25). Information about drugs profile, macronutrient intake (3 days diet recall reported as % equivalent of energy) and serum glucose profile were obtained at baseline and a 6th month follow up. Mean CHO, protein and fat intakes were 65.4±4.84, 12.6±1.26 and 22.0±4.7 % of total energy at baseline and remained essentially similar at 6th month. Patients who had controlled glycemic status (HbA1C â‰¤ 7 %) consumed 63.4±2.70 % CHO which was significantly (P<0.05) lower than those with not-controlled glycemic status (HbA1C >7 %) during both the assessment periods. Also, mean protein intake was higher and fat intake was lower among patients with good glycemic control. Significantly a higher proportion of (P<0.05) patients consuming CHO > 65 % were on dual therapy. A diet with lower carbohydrates and fat but high protein exerted good glycemic control. Number of OADs and their dosages were significantly associated to CHO intakes. Since Indian diets are predominantly carbohydrate rich, it calls for a careful management of diet among Type 2 diabetes patients
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Tabish, S.A. Is diabetes becoming the biggest epidemic of the twenty-first century? Int. J.Health Sci (Qassim)., 2007, 1, V–VIII.
Hailu, E., Mariam,W.H., Belachew, T and Birhanu, Z. Self-care practice and glycaemic control amongst adults with diabetes at the Jimma University Specialized Hospital in South-West Ethiopia: A cross-sectional study. Afr. J. Prim. Health Care Fam. Med., 2012, 4, 311.
Stratton, I.M., Adler, A.I., Neil, H.A. et al. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.BMJ., 2000, 321, 405.
Nathan, D.M., Cleary, P.A., Backlund J.Y., et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N. Engl. J., 2005, 353, 2643-2653.
American Diabetes Association (ADA). Standards of medical care in diabetes. Diabet. Care., 2015, 38, 33-40.
Emami-Riedmaier, A., Schaeffeler, E., Nies, A.T., et al. Stratified medicine for the use of antidiabetic medication in treatment of type II diabetes and cancer: where do we go from here.
J. Intern. Med., 2015, 277, 235-247.
Chamberlain, J.J., Rhinehart, A.S., Shaefer, C.F. and Neuman, A. Diagnosis and management of diabetes: synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann. Intern. Med., 2016, 164, 542-552.
Chatterjee, S. and Davies, M. J. Current management of diabetes mellitus and future directions in care. Postgrad. Med. J., 2015, 91, 612-621.
Sami, W., Ansari, T., Butt, N.S. and Hamid, M. R. A Effect of diet on type 2 diabetes mellitus: A review. Int. J. Health Sci (Qassim)., 2017, 11, 65-71.
Forouhi, N.G., Misra, A., Mohan, V., Taylor, R. and Yancy, W. Dietary and nutritional approaches for prevention and management of type 2 diabetes. BMJ., 2018, 361, 2234.
Shobana, R., Snehalatha, C., Latha, E., Vijay, V. and Ramachandran, A. Dietary profile of urban South Indians and its relations with glycaemic status. Diabet. Res. Clin. Pract., 1998, 42, 181-186.
Sivasankari, V., Manobala, K., Geetha ,G., et al. Dietary profile of Chennai urban adults with diabetes. Poster at RSSDI 2012 (Abstract).
Joshi, S.R., Bhansali, A., Bajaj ,S., Banzal, S.S., et al. Results from a dietary survey in an Indian T2DM population: a STARCH study. BMJ. Open., 2014, 4, e005138.
Feinman, R.D., Pogozelski, W.K., Astrup, A., et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutr., 2015, 31, 1-13.
Rietman, A., Schwarz, J., Tomé, D., Kok, F.J. and Mensink, M. High dietary protein intake, reducing or eliciting insulin resistance?. Eur. J. Clin. Nutr., 2014, 68, 973-979.
Nuttall, F.Q., Mooradian, A.D., Gannon, M.C., et al. Effect of protein ingestion on the glucose and insulin response to a standardized oral glucose load. Diabet. Care., 1984, 7, 465-470.
Lichtenstein, A.H. and Schwab, U.S. Relationship of dietary fat to glucose metabolism.Atherosclerosis, 2000, 150, 227-243.
Rebrin, K., Steil, G. M., Mittelman, S. D. and Bergman, R.N. Causal linkage between insulin suppression of lipolysis and suppression of liver glucose output in dogs. J. Clin. Invest., 1996, 98, 741-749.
Misra, A., Sharma, R., Gulati, S. and Joshi, S.R. Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes and related disorders in Asian Indians. Diabet. Technol. Ther., 2011, 13, 683-694.
Franz, M.J. Protein: metabolism and effect on blood glucose levels. Diabet. Educ. 1997, 23, 643-646, 648, 650-651.
Nuttall, F.Q. and Gannon, M.C. Plasma glucose and insulin response to macronutrients in nondiabetic and NIDDM subjects. Diabet. Care., 1991,14, 824–838.
Eiswirth, M., Clark, E. and Diamond, M. Low carbohydrate diet and improved glycaemic control in a patient with type one diabetes. Endocrinol. Diabet. Metab. Case. Rep., 2018, 21, 1-5.
Gannon, M.C., Nuttall, F.Q., Westphal, S.A, Neil, B.J. and Seaquist, E.R. Effects of dose of ingested glucose on plasma metabolite and hormone responses in type II diabetic subjects. Diabet. Care. 1989, 12, 544–552,
Mann, J. I., De Leeuw I., Hermansen, K., et al. Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus. Nutr. Metab. Cardiovasc. Dis., 2004, 14, 373394.
Gannon, M.C., Nuttall, F.Q., Saeed, A., Jordan, K. and Hoover, H. An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. Am. J. Clin. Nutr., 2003, 78, 734-741.
Wolpert, H.A., Atakov-Castillo, A., Smith, S.A. and Steil, G.M. Dietary fat acutely increases glucose concentrations and insulin requirements in patients with type 1 diabetes: implications for carbohydrate-based bolus dose calculation and intensive diabetes management. Diabet.Care, 2013, 36, 810–816.
Savage, D.B., Petersen, K.F. and Shulman, G. I. Disordered lipid metabolism and the pathogenesis of insulin resistance. Physiol. Rev., 2007, 87, 507–520.
Normand, S., Khalfallah, Y., Louche-Pelissier, C., Pachiaudi, C., Antoine, J.M., Blanc, S., Desage, M., Riou, J.P. and Laville, M. Influence of dietary fat on postprandial glucose metabolism (exogenous and endogenous) using intrinsically (13) C-enriched durum wheat. Br. J. Nutr., 2001, 86, 3-11.