Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial

Linda M DELAHANTY; David M NATHAN; John M LACHIN; Frank B HU; Patricia A CLEARY; Georgia K ZIEGLER; Judith WYLIE-ROSETT; Deborah J WEXLER; Diabetes Control and Complications Trial/Epidemiology of Diabetes

doi:10.3945/ajcn.2008.26498

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Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial

Journal article

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Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial

Linda M DELAHANTY, David M NATHAN, John M LACHIN, Frank B HU, Patricia A CLEARY, Georgia K ZIEGLER, Judith WYLIE-ROSETT, Deborah J WEXLER and Diabetes Control and Complications Trial/Epidemiology of Diabetes

The American journal of clinical nutrition, Vol.89(2), pp.518-524

2009

DOI: 10.3945/ajcn.2008.26498

PMID: 19106241

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Abstract

Background: Persons with type 1 diabetes have received widely varying dietary advice based on putative effects on glycemic control. Objective: The objective was to determine whether diet composition was associated with subsequent glycated hemoglobin (Hb A1c) concentrations during intensive therapy for type 1 diabetes. Design: We examined associations between quantiles of dietary intake and Hb A1c adjusted for age and sex in 532 intensively treated participants in the Diabetes Control and Complications Trial (DCCT) who had complete dietary data through 5 y of follow-up. Multivariate macronutrient density linear regression models tested the association of Hb A1c at year 5 with macronutrient composition and were adjusted for age, sex, exercise, triglyceride concentration, body mass index (BMI), baseline Hb A1c, and concurrent insulin dose. Results: Higher insulin dose, lower carbohydrate intake, and higher saturated, monounsaturated, and total fat intakes were associated with higher Hb A1c concentrations at year 5. In age- and sex-adjusted multivariate macronutrient models, substitution of fat for carbohydrate was associated with higher Hb A1c concentrations (P = 0.01); this relation remained significant after adjustment for exercise level, serum triglycerides, and BMI (P = 0.02) but was no longer significant (P = 0.1) after adjustment for baseline Hb A1c and concurrent insulin dose. Conclusion: Among intensively treated patients with type 1 diabetes, diets higher in fat and saturated fat and lower in carbohydrate are associated with worse glycemic control, independent of exercise and BMI.

Fundamental and applied biological sciences. Psychology

Feeding. Feeding behavior

Biological and medical sciences

Vertebrates: anatomy and physiology, studies on body, several organs or systems

Details

Title: Subtitle: Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial
Creators: Linda M DELAHANTY - Massachusetts General Hospital Diabetes Center and Harvard Medical School, Boston, MA, United States
David M NATHAN - Massachusetts General Hospital Diabetes Center and Harvard Medical School, Boston, MA, United States
John M LACHIN - George Washington University Biostatistics Center, Rockville, MD, United States
Frank B HU - Harvard School of Public Health, Boston, MA, United States
Patricia A CLEARY - George Washington University Biostatistics Center, Rockville, MD, United States
Georgia K ZIEGLER - Mayo Clinic, Rochester, MN, United States
Judith WYLIE-ROSETT - Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
Deborah J WEXLER - Massachusetts General Hospital Diabetes Center and Harvard Medical School, Boston, MA, United States
Diabetes Control and Complications Trial/Epidemiology of Diabetes
Contributors: H Culver Boldt (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Resource Type: Journal article
Publication Details: The American journal of clinical nutrition, Vol.89(2), pp.518-524
DOI: 10.3945/ajcn.2008.26498
PMID: 19106241
NLM abbreviation: Am J Clin Nutr
ISSN: 0002-9165
eISSN: 1938-3207
Publisher: American Society for Nutrition
Language: English
Date published: 2009
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9984083861602771

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