Association of Dietary Patterns with Glycated Hemoglobin (HbA1c) among Type 2 Diabetes Patients: A Cross-sectional Study

Background: The prevalence of diabetes mellitus is increasing inexplicably day by day worldwide. When it is not controlled, it has dire consequences for health. However, diet is the main factor in triggering glycemic parameters. Objectives: This study was designed to investigate the association between dietary intake and glycated hemoglobin among Type 2 Diabetes Mellitus (T2DM) patients. Methods: In total, 98 previously diagnosed T2DM patients in Tangail, Bangladesh, were evaluated. Dietary patterns were evaluated using a validated food frequency questionnaire. Relevant biochemical, socio-demographic, anthropometric, and diabetes-related information assays were carried out using the standard protocol. Results: Respondent's mean energy intake was found to be 1752 kcal/day. The ratio of energy supplied by protein, fat, and carbohydrate was 15.4%, 25.7%, and 59.9%, respectively. In this study, the mean HbA1c in type 2 diabetic patients was found to be 8.9%. The high HbA1c group (HbA1c >10.0%) had significantly lower protein, fat, and carbohydrate intake than other low HbA1c groups (HbA1c <6.5%, 6.5-8.0%, 8.0-10.0%). No significant association was found between carbohydrate intake and HbA1c (p=0.331). Also, after adjusting for diabetes treatment, there was no significant relationship found between carbohydrate intake and change in HbAlc in any of the three treatments (Diet + Oral Hypoglycemic Agents, Diet + Insulin, and Diet + Oral Hypoglycemic Agents + Insulin) strata. Whereas, there was a significant relationship found between carbohydrate intake and change in HbAlc in only diet treatment patients (P<0.001). There was no significant association found between protein intake and HbA1c (chi(2)(3)>=0.790, p=0.852). Conclusion: The dietary carbohydrate, protein and fat exhibited no significant relationship with HbA1c, suggesting that any factors without diet could be responsible for increasing glycated hemoglobin.