title: Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity.
abstract: OBJECTIVE
  Patients with type 2 diabetes (T2DM) demonstrate low dietary adherence and this is further aggravated with comorbid obesity. The aim of the present study was to assess diet quality in patients with T2DM and comorbid obesity compared to patients with T2DM alone and to examine the associations between comorbidities and diet quality.
  
  
  METHODS
  The sample consisted of 59 adult patients with diabesity (T2DM and comorbid obesity) and 94 patients with T2DM alone. All diabetes comorbidities and complications were recorded and diet quality was assessed with the Healthy Eating Index (HEI).
  
  
  RESULTS
  Mean raw HEI of the diabese subjects was 81.9±7.1 and the diabetic subjects was 80.2±6.9. When HEI was adjusted to the sex, age and weight status, the diabese demonstrated a higher HEI. Among comorbidities, only renal disease decreased HEI. According to the principal component analysis of the total sample, adequate diet quality was explained by cardiovascular disease, cigarette smoking, alcohol consumption, peptic ulcer, sex, diabesity and diabetic foot syndrome. In the diabese, adequate HEI was explained by diabetic foot syndrome, smoking, drinking alcohol and having a family history of diabetes.
  
  
  CONCLUSIONS
  Adult patients with T2DM demonstrate adequate diet quality. Different factors are associated with the adoption of a high quality diet between the diabese and the T2DM alone.
authors.affiliation: Department of Human Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece.
authors.forename: Apostolis
authors.initials: A
authors.lastname: Mangou
authors.forename: Maria G
authors.initials: MG
authors.lastname: Grammatikopoulou
authors.forename: Daphne
authors.initials: D
authors.lastname: Mirkopoulou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sailer
authors.forename: Charalambos
authors.initials: C
authors.lastname: Kotzamanidis
authors.forename: Maria
authors.initials: M
authors.lastname: Tsigga
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004032:Diet; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*