Abstract
Type 2 diabetes mellitus (T2DM) is a global public health epidemic. Diet and lifestyle changes have been demonstrated as effective measures in managing T2DM and preventing or delaying the progression from prediabetes to diabetes, yet the relationship between diet, prediabetes and diabetes is still not entirely clear. The present study aimed to further elucidate the relationship between diet, diabetes and especially prediabetes. A total of 1542 participants of the cross-sectional, population-based Cooperative Health Research in the Region of Augsburg (KORA) FF4 study (2013/2014) were included in this analysis. Dietary intake was derived using a method combining information from a FFQ and repeated 24-h food lists. Glucose tolerance status was assessed via oral glucose tolerance tests in all participants without a previous physician-confirmed diagnosis of T2DM, and was classified according to the 2003 American Diabetes Association criteria. Crude and fully adjusted multinomial logistic regression models were fitted to examine associations between diet and prediabetes, undetected diabetes mellitus (UDM) and prevalent T2DM. After adjusting for major covariates, fruit was significantly inversely and total meat, processed meat, sugar-sweetened beverages and moderate alcohol significantly associated with UDM and/or prevalent diabetes. Sex-specific analyses showed that in men, coffee was significantly inversely (OR 0·80; 95% CI 0·67, 0·96) and heavy alcohol significantly (OR 1·84; 95% CI 1·14, 2·95) associated with prediabetes. Our findings on diet and T2DM are consistent with current literature, while our results regarding coffee, heavy alcohol consumption and prediabetes highlight new possible targets for primary prevention of the derangement of glucose homeostasis.
Highlights
Of the 1542 participants included in the analyses, 789 (51·2 %) had Normal glucose tolerance (NGT), 545 (35·3 %) had prediabetes, sixty-five (4·2 %) had undetected diabetes mellitus (UDM) and 143 (9·3 %) had prevalent diabetes
Hypertension and a family history of diabetes were more prevalent in participants with prediabetes, UDM and prevalent diabetes than in individuals with NGT
As a high percentage of individuals with prediabetes may progress to developing Type 2 diabetes mellitus (T2DM), a widespread disease with high personal and economic costs, it is imperative that interventions be focused on managing T2DM, and on primary prevention[1,2,3]
Summary
Costs associated with T2DM were estimated to be €33·3 billion in Germany in 2010, with total healthcare costs for people with diabetes estimated to be three times higher than for people without diabetes[1]. This disease is associated with numerous adverse outcomes and complications for the patient, especially concerning macro- and microvascular disease progression[2,3]. The aim of the present study was to examine the cross-sectional association between dietary intake, prediabetes and T2DM in the Cooperative Health Research in the Region of Augsburg (KORA) FF4 study population, in order to better inform future prospective and experimental investigations
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