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

Abstract

Aims/Introduction: The present study investigated the relationship between the macronutrient energy ratio, dietary carbohydrate and glycated hemoglobin levels in Japanese patients with type 2 diabetes, to generate a potential optimal dietary intake of macronutrients for such patients. Materials and Methods: In total, 3,032 patients participating in the Sleep and Food Registry in Kanagawa study were evaluated. Their diets were assessed for macronutrient content through a brief self-administered dietary history questionnaire. Relevant biochemical assays were carried out. Results: The mean energy intake (-standard deviation) was 1,711 -645 kcal/day. The proportion of energy supplied by protein, fat and carbohydrate were 16.3, 26.8 and 52.3%, respectively. Total fiber intake was 12.6 -5.7 g/day. The high glycated hemoglobin (HbA1c) group (HbA1c >8%) had significantly lower protein and higher carbohydrate intake than the low HbA1c group (HbA1c <6.5%). Higher HbA1c levels were positively correlated with unfavorable metabolic factors, including elevated body mass index and excess carbohydrate intake, and negatively correlated with age, protein intake and fiber intake. Multiple regression analysis showed a significant association between HbA1c and carbohydrate intake after adjusting for sex, age and body mass index (0.104, P < 0.0001). Additionally, patients within the uppermost tertile for the percentage of total energy intake from carbohydrate (>60%) were most likely to have high HbA1c levels. HbA1c was significantly correlated with carbohydrate (%E) in all age groups and in patients taking one or two antidiabetic drugs. Conclusions: The dietary carbohydrate:energy ratio has a positive correlation with HbA1c, suggesting that avoiding excessive carbohydrate intake (>60%) might help foster glycemic control.

Effects of sprouted and fermented quinoa (Chenopodium quinoa) on glycemic index of diet and biochemical parameters of blood of Wistar rats fed high carbohydrate diet

“…The assessment of HbA1 levels is the best option for evaluating medium-and long-term glycemic control (Bem and Kunde 2006). According to Yamakawa et al (2018), dietary carbohydrate to energy ratio has a positive correlation with HbA1c, suggesting that avoiding excessive carbohydrate intake ([ 60%) may help foster glycemic control in humans. These results also corroborate those from Abellán Ruiz et al (2017), who shown that processed quinoa intake during 28 days decreased HbA1c levels and the satiation and fullness (complete) degree in prediabetic patients.…”

The Association Between Body Mass Index and Glycemic Control in Patients with Type 2 Diabetes Across Eight Countries: A Literature Review

“…There were 10 prospective studies and seven retrospective studies. Of the 10 prospective studies, six were cross-sectional and only gathered data at one time point [10][11][12][13][14][15]; four were longitudinal, but only baseline demographic data were used in our analysis [16][17][18][19]. Seven retrospective studies were identified [2,[20][21][22][23][24][25]; in six of these, baseline data from the cohorts were used for our analysis; the other study [20] was different in that it looked at data over time, presenting the relative risk for having HbA 1c >7% presented by BMI category at 1-, 2-, 3-, and 5-year follow-up.…”

“…A range of different sources were used to capture the data relevant to our analysis. These included medical records [2,12,[20][21][22][23][24][25], study data [10,[14][15][16][17][18][19], and data from the Diabetes Specific Programme [11]. Most studies were from were from Asia (China, n=9; Japan, n=3; Hong Kong, n=1), followed by the USA (n=2), Spain (n=1), and the UK (n=1).…”

Dietary recommendations for type 2 diabetes patients: Lessons from recent clinical and basic research in Asia

“…Mice fed a high-starch diet, the final product of which is glucose, show obesity 4 ; mice fed a high-sucrose diet, the final product of which is glucose and fructose, show glucose intolerance due to reduced glucokinase activity in the liver and impaired glucagon-like peptide-1 secretion 5 , showing that a high-carbohydrate diet contributes to bodyweight gain and worsens glycemic control. Indeed, glycated hemoglobin levels were found to be positively correlated with carbohydrate intake and BMI in Japanese type 2 diabetes patients 6 . In addition, glycated hemoglobin levels have been shown to be negatively correlated with fiber intake in Japanese type 2 diabetes patients 6 .…”

“…Indeed, glycated hemoglobin levels were found to be positively correlated with carbohydrate intake and BMI in Japanese type 2 diabetes patients 6 . In addition, glycated hemoglobin levels have been shown to be negatively correlated with fiber intake in Japanese type 2 diabetes patients 6 .…”