USUAL DIETARY-INTAKE AND HEMOGLOBIN A(1) LEVEL IN PATIENTS WITH INSULIN-DEPENDENT DIABETES

Objective To explore epidemiologic evidence for the relation ship betw een dietary intake and glycemic control. Design/subjects We examined u sual dietary intake, assessed by a food frequency questionnaire, from a random sample (n=136) of patients who had had insulin-dependent diab etes mellitus for 15 to 21 years. Results In men, absolute intakes of energy, carbohydrate, protein, fat, and dietary fiber were positively correlated with hemoglobin A(1) (HbA(1)) (P<.05); Spearman correlation coefficients (gamma(s)) were .28,.22,.28,.34, and.25, respectively. I n women, the correlations were weaker and not significant; gamma(s) va lues were .18,.13,.17,.19, and .16, respectively. When these nutrients were expressed as a percentage of energy or as an amount per 1,000 kc al, only percentage of energy from fat showed a significant associatio n with HbA(1)-but only in men (gamma(s)=.23 for ren and.02 for women). Adjustment for body weight, insulin dose, and physical activity using multiple regression analysis did not change the relationship between HbA(1) and intakes of energy and fat. Sucrose and alcohol intakes did not show any association with HbA,. Conclusions Among men with insulin -dependent diabetes mellitus, the major dietary correlates of poor gly cemic control were high intake of energy and percentage of energy from fat. Further investigation is needed to confirm this relationship of energy, fat, and glycemic control.