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.


METHODS
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 A1 (HbA1) (P < .05); Spearman correlation coefficients (rs) were .28, .22, .28, .34, and .25, respectively. In women, the correlations were weaker and not significant; rs 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 HbA1--but only in men (rs = .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 HbA1 and intakes of energy and fat. Sucrose and alcohol intakes did not show any association with HbA1.


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.
Shimakawa
T
T
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, MD 20892.
Warram
J H
JH
Herrera-Acena
M G
MG
Krolewski
A S
AS
D000328:Adult; D000428:Alcohol Drinking; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000378:metabolism; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004435:Eating; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D012044:Regression Analysis; D011795:Surveys and Questionnaires
D004041:Dietary Fats; D006442:Glycated Hemoglobin; D007328:Insulin