Usual dietary intake and hemoglobin A1 level in patients with insulin-dependent diabetes

Objective To explore epidemiologic evidence for the relationship between dietary intake and glycemic control. Design/subjects We examined usual dietary intake, assessed by a food frequency questionnaire, from a random sample (n = 136) of patients who had had insulin-dependent diabetes 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 r s ) were .28, .22, .28, 34, and .25, respectively. In women, the correlations were weaker and not significant; r s values 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 kcal, only percentage of energy from fat showed a significant association with HbA 1 —but only in men ( r s =.23 for men 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 1 . Conclusions Among men with insulin-dependent diabetes mellitus, the major dietary correlates of poor glycemic 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.