Abstract
PurposeTo investigate whether adherence to the Dutch Healthy Diet index 2015 (DHD15-index) is associated with change in glycemic control and cardio-metabolic markers over two-year follow-up in people with type 2 diabetes (T2D).MethodsThis prospective cohort study included 1202 individuals with T2D (mean age 68.7 ± 9.0 years; 62.5% male; mean HbA1c 53.8 ± 11.7 mmol/mol) from the Diabetes Care System cohort. Baseline dietary intake was assessed using a validated food frequency questionnaire, and adherence to the DHD15-index was estimated (range 0–130). HbA1c, fasting glucose, blood lipids (HDL and LDL cholesterol, cholesterol ratio), blood pressure, estimated glomerular filtration rate (eGFR), and BMI were measured at baseline, and after one- and two-year follow-up. Linear mixed model analyses were conducted to examine the associations between adherence to the DHD15-index and glycemic control and the cardio-metabolic outcomes, adjusting for energy intake, sociodemographic and lifestyle characteristics, and medication.ResultsHighest adherence (T3) to the DHD15-index was not associated with change in HbA1c, compared to lowest adherence (T1) [βT3vsT1: 0.62 mmol/mol (− 0.94; 2.19), Ptrend = 0.44]. There was a non-linear association with fasting glucose, where moderate adherence (T2) was associated with a decrease in fasting glucose [βT2vsT1: − 0.29 mmol/L (− 0.55; − 0.03), Ptrend = 0.30]. Higher adherence to the DHD15-index was associated with a decrease in BMI [β10point: − 0.41 kg/m2 (− 0.60; − 0.21), Ptrend < 0.001], but not with blood lipids, blood pressure or kidney function.ConclusionIn this well-controlled population of people with T2D, adherence to the DHD15-index was associated with a decrease in BMI, but not with change in glycemic control or other cardio-metabolic parameters.
Highlights
It is important to improve diabetes management to prevent comorbidities and complications among people with type 2 diabetes (T2D), such as cardiovascular disease, nephropathy, retinopathy and neuropathy [1]
The same procedure was applied for missing data in the secondary outcomes: high-density lipoprotein (HDL) cholesterol (n = 56), low-density lipoprotein (LDL) cholesterol (n = 57), cholesterol ratio (n = 56), systolic blood pressure (SBP) (n = 54), diastolic blood pressure (DBP) (n = 54), estimated glomerular filtration rate (n = 55), and body mass index (BMI) (n = 56)
This study aimed to investigate the association between adherence to the DHD15-index at baseline and change in glycemic control and cardio-metabolic markers over one and two years of follow-up in people with T2D being wellcontrolled in the Diabetes Care System
Summary
It is important to improve diabetes management to prevent comorbidities and complications among people with type 2 diabetes (T2D), such as cardiovascular disease, nephropathy, retinopathy and neuropathy [1]. Studies have shown that adequate dietary management is associated with a reduction in hemoglobin A1c (HbA1c) levels of 11.0–22.0 mmol/mol [4]. European Journal of Nutrition (2022) 61:2761–2773 control [6–9], and intake of low glycemic index fruits, nuts and wholegrain products with improved cardio-metabolic markers in people with T2D [6, 8, 10]. Systematic reviews of randomized controlled trials (RCTs) on dietary patterns, such as the Mediterranean diet score, have shown beneficial effects of the Mediterranean diet on glycemic control and cardio-metabolic markers in Western populations, reducing HbA1c by 1.1–6.6 mmol/mol [11–14], fasting glucose by 0.4–2.2 mmol/L [11, 13], low-density lipoprotein (LDL) cholesterol non-significantly by 0.08–0.19 mmol/L, increasing high-density lipoprotein (HDL) cholesterol by 0.04–0.09 mmol/L [11, 14, 15], and reducing systolic blood pressure (SBP) by 1.45 mm Hg, diastolic blood pressure (DBP) by 1.41 mm Hg, and body mass index (BMI) by 0.29 kg/m2 [11]. The Mediterranean diet cannot directly be translated to the Dutch dietary behavior
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
