P15 Low-Carbohydrate Diet was Not Associated with Diabetic Retinopathy: Results From US Representative Adults with Diabetes Mellitus

Abstract

Background As there are no specific dietary recommendations for people with diabetes mellitus (DM), they can choose eating patterns, which they deem helpful in managing blood glucose levels. Objective To describe the dietary intakes of people with DM and to examine the association between the low- carbohydrate-diet (LCD) pattern and diabetic retinopathy (DR). Study Design, Settings, Participants Cross-sectional analysis of the 2005 to 2016 National Health and Nutrition Examination Survey (NHANES). Secondary database analysis. Population-based sample of 3,313 participants with DM in the NHANES 2005-2016. Measurable Outcome/Analysis The presence of DR was self-reported, and LCD score was calculated based on the proportions of energy from three macronutrients (range 0-30; a higher LCD score indicates a lower intake of carbohydrate). The relative risk of DR comparing highest and lowest quintiles of the LCD score was evaluated in multiple logistic regression analysis. Results The average diet of adults with DM consisted of 48 ± 11% of carbohydrate and 35 ± 10% of fat with a mean LCD score of 15.0 ± 7.4. 20.6% of participants reported having DR, and it was associated with male gender, non-Hispanic Blacks and other race/ethnicity, smoking, overweight/obesity, lower education, lower income, HgA1c, and time since diagnosis. After multivariable adjustment, the odds ratio (OR) of having DR comparing highest (carbohydrate 33.9%) and lowest (carbohydrate 62.9%) quintile of the LCD score was 1.01 (95% confidence interval [CI], 0.59 to 1.72; Ptrend = 0.4702). There was no difference in HgA1c levels between the comparison groups (7.51 ± 1.94 vs. 7.40 ± 1.85; P = .131). Post-hoc analysis showed higher diet quality was associated with decreased risk of DR among males (OR comparing highest and lowest quintile, 0.44; 95% CI, 0.20 to 0.98; Ptrend = 0.074). Conclusion Diets lower in carbohydrate are not associated with decreased risk of DR in adults with DM. Targeting diet quality may have greater impacts on improving diabetic prognosis. Funding University of Central Florida.