A Comparative Study of Diet in Good and Poor Glycemic Control Groups in Elderly Patients with Type 2 Diabetes Mellitus

Abstract

BackgroundIdentification of dietary patterns is important for glycemic management in elderly patients with type 2 diabetes mellitus (T2DM).MethodsElderly T2DM patients (> 65 years of age, n = 48) were categorized based on their concentration of glycated hemoglobin (HbA1c). Subjects with HbA1c levels below 7% were placed in the good control (GC) group and those with HbA1c levels equal to or above 8% were placed in the poor control (PC) group. Anthropometric data, blood parameters, and dietary intake records were compared between the groups. Statistical analysis included Student's t-test, chi-square test, and Pearson correlation coefficient test.ResultsAnthropometric data, including body mass index (24.7 ± 2.9 kg/m2), did not differ between the GC and PC groups. Significant abnormalities in blood glucose levels (P < 0.01), lean body mass (P < 0.01), and plasma protein and albumin levels (P < 0.05, P < 0.01) were found in the PC group. In contrast to the GC group, the PC group depended on carbohydrate (P = 0.014) rather than protein (P = 0.013) or fat (P = 0.005) as a major source of energy, and had a lower index of nutritional quality for nutrients such as protein (P = 0.001), and all vitamins and minerals (P < 0.001, 0.01, or 0.05 for individual nutrients), except vitamin C, in their usual diet. Negative correlations between HbA1c levels and protein (r = -0.338, P < 0.05) or fat (r = -0.385, P < 0.01) intakes were also found.ConclusionsHealthcare professionals should encourage elderly diabetic patients to consume a balanced diet to maintain good glycemic control.

Dietary survey in Japanese patients with type 2 diabetes and the influence of dietary carbohydrate on glycated hemoglobin: The Sleep and Food Registry in Kanagawa study

“…As expected, the results of the present study showed a significant positive association between higher calorie intake and increased HbA1c, even after adjustment for total energy intake. A previous cross‐sectional Korean study and two prospective studies obtained similar results, though the sample sizes were small. In contrast, both JDCS and J‐EDIT found no correlation between the carbohydrate energy ratio and HbA1c.…”

Optimal energy distribution of carbohydrate intake for Japanese elderly patients with type 2 diabetes: The Japanese Elderly Intervention Trial

“…In a study that examined nutritional intakes in good (GC) and poor (PC) glycemic control groups in elderly Korean patients with type 2 diabetes mellitus, the distribution of macronutrients differed significantly between GC group (%E of protein : %E of fat : %E of carbohydrate = 19:22:62) and PC group (%E of protein : %E of fat : %E of carbohydrate = 15:15:71). This result shows that the PC group had higher carbohydrate intake compared with the GC group 15 . Furthermore, negative correlations between HbA1c levels and protein or fat intake were also observed.…”

“…The Korean study showed the significant positive correlation of %E of carbohydrate with the exacerbation of HbA1c 15,16 . However, %E of carbohydrate in Korean elderly diabetic patients was substantially high.…”

“…This result shows that the PC group had higher carbohydrate intake compared with the GC group. 15 Furthermore, negative correlations between HbA1c levels and protein or fat intake were also observed. In another study using Korean patients with diabetes mellitus, the distribution of macronutrients (%E of protein : %E of fat : %E of carbohydrate) was reported as 16:16:68.…”

“…The Korean study showed the significant positive correlation of %E of carbohydrate with the exacerbation of HbA1c. 15,16 However, %E of carbohydrate in Korean elderly diabetic patients was substantially high. On the contrary, extremely low intake of carbohydrate (21 g/ day) and extremely low %E of carbohydrate, was reported to improve HbA1c levels.…”