Abstract
Medical nutrition therapy is an important part of the management of type 1 diabetes mellitus (T1DM). Proper adherence to a healthy diet may have a favorable impact on diabetes management and its diabetic complications. Our aim was to assess differences in food and nutrient intake of type 1 diabetic patients with and without diabetic retinopathy (DR). This was a two-center, cross-sectional study in patients with T1DM, with and without DR. Subjects were recruited from the outpatient clinic of the two participating centers. A validated food frequency questionnaire was administered. A total of 103 T1DM patients with DR and 140 T1DM patient without DR were recruited. Subjects with DR showed a lower intake of total fat (p = 0.036) than that of their non-DR counterparts. DR was associated with increasing age (p = 0.004), hypertension (p < 0.001), and diabetes duration (p < 0.001), however there was a negative association with high educational level (p = 0.018). The multivariate-adjusted analysis showed that the intake of complex carbohydrates was positively related to the presence of DR (p = 0.031). In contrast, the intakes of total fat (p = 0.009), monounsaturated fatty acids (MUFAs) (p = 0.012), oleic acid (p = 0.012), and vitamin E (p = 0.006) were associated with the absence of DR. As conclusions, the intake of total MUFAs, oleic acid, and vitamin E is associated with a lower frequency of DR in patients with T1DM. These results suggest a potential protective effect of these lipid components for DR.
Highlights
Diabetic retinopathy (DR) is an important cause of visual impairment in patients with type 1 diabetes mellitus (T1DM) [1]
Our results suggest that the intake of total fat, monounsaturated fatty acids (MUFAs), oleic acid, and vitamin E is associated with the absence of diabetic retinopathy (DR) in subjects with T1DM
In terms of total fat and MUFA intake, the present results are discordant with the results of a sub-study of the DCCT trial, which found an association between the increased intake of fat, SFAs and MUFAs and the presence of DR [6]; these researchers did not adjust for potential confounders [5], i.e., age, sex, smoking, diabetes duration, glycated hemoglobin (HbA1c), body mass index (BMI), and the presence of hypertension or dyslipidemia
Summary
Diabetic retinopathy (DR) is an important cause of visual impairment in patients with type 1 diabetes mellitus (T1DM) [1]. Association for the Study of Diabetes (EASD) establish that medical nutrition therapy (MNT) plays an important role in preventing complications related to the management and metabolic control of the disease [3]. These nutritional recommendations are based on the Mediterranean Diet, which has benefits to prevent cardiovascular diseases in the diabetic population. A controversy exists with the few published studies, regarding the relationship between the dietary intake and the presence of DR in patients with diabetes, describing controversial results between them [4,5]. The relationship between dietary intake and DR development in patients with
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