Abstract
BackgroundDietary intake impacts glycaemic control through its effect on weight and glucose-insulin homeostasis. Early glycaemic control is associated with improved outcomes and reduced mortality for people with type 2 diabetes (T2D). To date, the diet quality of people with T2D has only been studied cross-sectionally. The objective of this paper is to quantify short-term improvements in diet quality and to identify factors associated with improvements after T2D diagnosis among participants in the 3D study.MethodsThis paper presents data from the 3D study of 225 Australian adults, newly diagnosed with T2D. Telephone interviews collected demographic, diet, physical and health data at baseline and 3 months. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) tool to examine short-term changes in diet quality after diagnosis. Participants were categorised into two groups: those who improved their diet quality by 3 months (increase in DASH score of 3 or more) and those who did not. Factors associated with change in DASH scores were clinically and statistically evaluated.ResultsThe 3D cohort was comparable to Australian cohorts with diabetes by gender and body mass index (BMI) but differed by age, remoteness and socioeconomic status. Mean (SD) baseline DASH score was 24.4 (4.7), in the midrange of possible scores between 8 and 40. One third of participants improved their DASH score by 3-months. This group had lower diet quality (p < 0.001), lower BMI (p = 0.045), higher physical activity levels (p = 0.028) and were less likely to smoke (p = 0.018) at baseline.ConclusionsDiet quality changes after diagnosis do not appear to be associated with demographic characteristics but were associated with lifestyle behaviours. Strategies targeted at better supporting smokers, those with low physical activity and higher BMI are required. Future research should investigate how the diet quality changes people make around time of diagnosis are related to long-term health outcomes.
Highlights
Lifestyle modification is the first line of treatment for people newly diagnosed with type 2 diabetes (T2D)[1].Dietary intake impacts glycaemic control through its effect on weight and glucose-insulin homeostasis[2]
Tight glycaemic control is associated with improved outcomes and reduced mortality for people with T2D, regardless of how the disease is managed in the future[3]
Dietary management guidelines for T2D suggest that personal preferences, cultural backgrounds, and metabolic goals should be considered when recommending one dietary pattern over another as no particular pattern will suit all people with T2D7
Summary
Lifestyle modification is the first line of treatment for people newly diagnosed with type 2 diabetes (T2D)[1].Dietary intake impacts glycaemic control through its effect on weight and glucose-insulin homeostasis[2]. Intervention studies have shown several dietary patterns to be effective in improving glycaemic control and other health outcomes in individuals with T2D such as hypertension and lipid profiles[4,5,6]. The DASH dietary pattern has been shown to be beneficial for glycaemic control, blood pressure, body weight, waist circumference and lipid levels in people with T2DM and was the dietary pattern used to assess diet quality in this study[8,9]. Glycaemic control is associated with improved outcomes and reduced mortality for people with type 2 diabetes (T2D). The objective of this paper is to quantify short-term improvements in diet quality and to identify factors associated with improvements after T2D diagnosis among participants in the 3D study
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