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Santos BC, Alves LF, Rocha VS, Hernandez-Ruiz Á, Silva AMO, Pires LV. Effectiveness of Health Action Interventions in Enhancing Diet Quality and Glycemic Control Among Individuals With Type 2 Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials. Nutr Rev 2024:nuae071. [PMID: 38894637 DOI: 10.1093/nutrit/nuae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Diet quality is directly related to glycemic control in individuals with type 2 diabetes mellitus (T2DM). The use of dietary indices can provide a comprehensive understanding of the relationship between diet quality and clinical outcomes. OBJECTIVE The aim was to evaluate the relationship between diet quality, measured using dietary indices, and its impact on improving glycemic control in individuals with T2DM through health interventions. DATA SOURCE This study was conducted using 6 databases, including Web of Science, MEDLINE (via PubMed), Embase, Bireme, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as the gray literature (Google Academic). DATA EXTRACTION Randomized clinical trials that evaluated the effectiveness of health interventions in adult and older adult individuals with T2DM and presented data on diet quality evaluated using dietary indices and the percentage of glycated hemoglobin (%HbA1c) were included. DATA ANALYSIS A total of 3735 articles were retrieved, 4 of which were included in the study selection stages. The quality indices assessed in the studies were the Alternate Healthy Eating Index (AHEI), Healthy Eating Index-2010 (HEI-2010), Diet Quality Index-International (DQI-I), and Diet Quality Index-Revised (DQI-R). A reduction in %HbA1c was observed in 2 studies, which correlated with the AHEI and DQI-I scores in the intervention groups. The approach of using food labels to improve diet quality reduced %HbA1c by 0.08% in the intervention group compared with the control group. Only 1 study found no significant association between the DQI-R index and %HbA1c. Additionally, negative correlations were observed between body weight and the AHEI and DQI-I scores. CONCLUSION Health interventions improved diet quality, glycemic control, and weight loss in individuals with T2DM. SYSTEMATIC REVIEW REGISTRATION PROSPERO no. CRD42023430036.
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Affiliation(s)
- Beatriz C Santos
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
| | - Luana F Alves
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
| | - Vivianne S Rocha
- Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe 49400-000, Brazil
| | - Ángela Hernandez-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Armilla, Granada 18016, Spain
- Department of Nursing, Faculty of Nursing, University of Valladolid, Valladolid 47005, Spain
| | - Ana Mara O Silva
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Sergipe 49060-100, Brazil
| | - Liliane V Pires
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil
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Santos CFDS, Santos BDC, de Carvalho GB, Oliveira JDS, Santos CB, Reis AR, Santos RKF, Brandão-Lima PN, da Costa SSL, Dos Santos SH, Rocha VDS, Pires LV. Magnesium Status and Dietary Patterns Associated with Glycemic Control in Individuals with Type 2 Diabetes Mellitus. Biol Trace Elem Res 2023; 201:5152-5161. [PMID: 36807884 DOI: 10.1007/s12011-023-03601-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/06/2023] [Indexed: 02/20/2023]
Abstract
Hypomagnesemia and unhealthy eating patterns are associated with poor glycemic control in individuals with type 2 diabetes mellitus (T2DM). This study aimed to associate magnesium status and dietary patterns with glycemic control in T2DM individuals. This cross-sectional study included 147 individuals with T2DM, aged between 19 and 59 years, of both sexes, residents in Sergipe/Brazil. The BMI, waist circumference, %body fat, plasma magnesium, serum glucose, insulin, %HbA1c, triacylglycerol, total cholesterol, LDL-c, and HDL-c were analyzed. Eating patterns were identified using a 24-h recall method. Logistic regression models were used to verify the association of magnesium status and dietary patterns with markers of glycemic control by adjusting for sex, age, time of T2DM diagnosis, and BMI. A P value < 0.05 was considered significant. Magnesium deficiency increased the chance of elevated %HbA1c by 5.893-fold (P = 0.041). Three main dietary patterns were identified: mixed (MDP), unhealthy (UDP), and healthy (HDP). UDP also increased the chance of elevated %HbA1c levels (P = 0.034). T2DM individuals' who presented magnesium deficiency had a higher chance of elevated %HbA1c levels (8.312-fold) and those in the lowest quartile (Q) of the UDP (Q1: P = 0.007; Q2: P = 0.043) had a lower chance of elevated %HbA1c levels. However, the lower quartiles of the HDP were associated with a greater chance of alterations in the %HbA1c level (Q1: P = 0.050; Q2: P = 0.044). No association was observed between MDP and the variables studied. Magnesium deficiency and UDP were associated with a higher chance of inadequate glycemic control in T2DM individuals.
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Affiliation(s)
- Cinthia Fontes da Silva Santos
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
| | - Beatriz da Cruz Santos
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
| | - Gabrielli Barbosa de Carvalho
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
- Nutrition in Public Health Post-Graduation Program, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Juliana de Souza Oliveira
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
| | - Cynthia Batista Santos
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
| | - Aline Rocha Reis
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
| | - Ramara Kadija Fonseca Santos
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
| | - Paula Nascimento Brandão-Lima
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil
- Nutrition in Public Health Post-Graduation Program, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Samir Hipólito Dos Santos
- Chemistry Post-Graduation Program, Chemistry Institute, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Liliane Viana Pires
- Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
- Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n - Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil.
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A dietary pattern high in full-fat dairy and sweetened beverages is associated with glycated hemoglobin and weight in Mexican patients with type-2 diabetes. NUTR HOSP 2021; 39:53-62. [PMID: 34743525 DOI: 10.20960/nh.03651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE the aim of this study was to identify dietary patterns in a sample of patients with type-2 diabetes, and to evaluate their association with markers of metabolic control. METHODS a cross-sectional study in 395 patients with type-2 diabetes in primary care was conducted. Fasting blood levels of glycated hemoglobin (A1c), glucose, total cholesterol, low- (LDL-c) and high-density lipoprotein cholesterol (HDL-c), and triglycerides were measured. Waist circumference, body mass index (BMI), and blood pressure were evaluated. Dietary intake was assessed by a food frequency questionnaire, and dietary patterns were derived by cluster analysis. Three dietary patterns were identified: 'fruits and vegetables', 'dairy and sweetened beverages', and 'diverse with alcohol'. RESULTS an association between the 'dairy and sweetened beverages' dietary pattern and A1c levels was identified (ß = 0.61; 95 % CI: 0.09, 1.12, p = 0.021), considering the 'fruits and vegetables' dietary pattern as the reference group. We also observed a trend towards an adjusted increased risk of A1c ≥ 7 % (odds ratio [OR]: 1.56; 95 % CI: 0.92, 2.64; p = 0.099) and an increased risk of BMI ≥ 25 kg/m2 (OR: 2.62, 95 % CI: 1.20, 5.71, p = 0.015) among patients in the 'dairy and sweetened beverages' dietary pattern as compared to the reference group. CONCLUSIONS a dietary pattern characterized by a high intake of full-fat dairy and sweetened beverages was associated with higher A1c levels and increased risk of high glucose and BMI when compared to a dietary pattern with a higher consumption of fruits and vegetables.
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Shen XM, Shu L, Huang YQ, Zhang XY, Zheng PF, Zhu Q. Association between dietary patterns and glycaemic control in a middle-aged Chinese population. Public Health Nutr 2021; 25:1-9. [PMID: 34509181 PMCID: PMC9991639 DOI: 10.1017/s1368980021003931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/16/2021] [Accepted: 09/06/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present work was performed to analyse the association of dietary patterns with glycaemic control (Hb A1c < 7 %) in a large group of Chinese adults aged between 45 and 59 years. DESIGN Habitual dietary intakes in the preceding 12 months were assessed by well-trained interviewers using a validated semi-quantitative FFQ. Factor analysis with principal component method was used to obtain the dietary patterns, and the associations between dietary patterns and glycaemic control were determined using multivariable logistic regression models. Poor glycaemic control was defined as HbA1c ≥ 7·0. SETTING Despite decades of research, data on the relationship between dietary patterns and glycaemic control (HbA1c < 7 %) in China are sparse. PARTICIPANTS A total of 1739 participants aged 45-59 years from Hangzhou were included in the final analysis. RESULTS Three dietary patterns were ascertained and labelled as traditional southern Chinese, Western and grains-vegetables patterns. After controlling of the possible confounders, participants in the highest quartile of Western pattern scores had greater OR for HbA1c ≥ 7·0 (OR = 1·05; (95 % CI 1·000, 1·095); P = 0·048) than did those in the lowest quartile. Compared with those in the lowest quartile of grains-vegetables pattern, participants in the highest quartile had lower OR for HbA1c ≥ 7·0 (OR = 0·82; (95 % CI 0·720, 0·949); P = 0·038). Besides, no significant relationship between the traditional southern Chinese pattern and HbA1c ≥ 7·0 was observed (P > 0·05). CONCLUSIONS This study indicated that the Western pattern was associated with a higher risk, and the grains-vegetables pattern was associated with a lower risk for HbA1c ≥ 7·0. Future prospective studies are needed to confirm our findings.
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Affiliation(s)
- Xiao-Ming Shen
- Department of Endocrinology, The No.1 People’s Hospital of Pinghu, Pinghu, Zhejiang, The People’s Republic of China
| | - Long Shu
- Department of Nutrition, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
| | - Yi-Qian Huang
- Department of Digestion, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
| | - Xiao-Yan Zhang
- Department of Nutrition, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
| | - Pei-Fen Zheng
- Department of Nutrition, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
- Department of Digestion, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
| | - Qin Zhu
- Department of Nutrition, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
- Department of Digestion, Zhejiang Hospital, Lingyin Road Number 12, Xihu District, Hangzhou310013, Zhejiang, The People’s Republic of China
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Velázquez-López L, Segura Cid Del Prado P, Colín-Ramírez E, Muñoz-Torres AV, Escobedo-de la Peña J. Adherence to non-pharmacological treatment is associated with the goals of cardiovascular control and better eating habits in Mexican patients with type 2 diabetes mellitus. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2021; 34:88-96. [PMID: 34103182 DOI: 10.1016/j.arteri.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify the association of diabetes education or medical nutrition therapy with the goals of control of cardiovascular risk indicators and dietary habits in patients with type 2 diabetes mellitus. METHODS Analytical cross-sectional study in 395 primary care patients. HbA1c, fasting glucose and lipid profile, blood pressure, weight, waist circumference, and body composition were measured. Dietary habits were measured using the «Instrument for measuring lifestyle in patients with type 2 diabetes mellitus» (IMEVID), in the nutrition dimension. Medical nutrition therapy (MNT) and diabetes education (DE) were considered as received by the patient when provided in their healthcare clinic. RESULTS Women comprised 68% of the patients, with a median of 6 years from diabetes diagnosis. Of the patients, 21% received DE and MNT, 28% DE or MNT, and 51% received neither. The HbA1c was lower in the patients with DE and MNT (7.7% ± 1.9% vs. 8.7% ± 2.3%, 8.4% ± 2.2%; p = .003) respectively. In the patients with DE and MNT, a higher proportion took physical exercise, consumed less tobacco, and had better dietary habits (p < .05). Patients who received DE and MNT achieved HbA1c and HDL-c control levels. A greater risk of HbA1c > 7% was identified when they only received DE or MNT or neither, a longer time since diagnosis of the disease and less frequent adherence to a diet to control the disease (p < .05). CONCLUSION Diabetes education and medical nutritional therapy favour the goal of cardiovascular risk control and better dietary habits in the patient with type 2 diabetes.
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Affiliation(s)
- Lubia Velázquez-López
- Unidad de Investigación en Epidemiología Clínica. Hospital Carlos MacGregor Sánchez Navarro. Instituto Mexicano del Seguro Social, Ciudad de México, México.
| | | | - Eloísa Colín-Ramírez
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac, Huixquilucan, Estado de México, México
| | - Abril Violeta Muñoz-Torres
- Departamento de Salud Pública. Facultad de Medicina. Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Jorge Escobedo-de la Peña
- Unidad de Investigación en Epidemiología Clínica. Hospital Carlos MacGregor Sánchez Navarro. Instituto Mexicano del Seguro Social, Ciudad de México, México
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Basu A, Alman AC, Snell-Bergeon JK. Associations of Dietary Patterns and Nutrients with Glycated Hemoglobin in Participants with and without Type 1 Diabetes. Nutrients 2021; 13:nu13031035. [PMID: 33806867 PMCID: PMC8004940 DOI: 10.3390/nu13031035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/15/2021] [Accepted: 03/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Diet has been associated with poor glycemic control in diabetes. Few studies have examined this association in people with type 1 diabetes (T1D), who are at a higher risk for cardiovascular disease than people without diabetes. Methods: We report data from cross-sectional and longitudinal analyses from a coronary artery calcification in type 1 diabetes (CACTI) study (n = 1257; T1D: n = 568; non-diabetic controls: n = 689) collected between the years 2000 and 2002. Participants completed a validated food frequency questionnaire, a physical examination, and biochemical analyses. Dietary patterns based on variations in food group intake were created with principal components analysis. Linear regression was used to examine the associations of dietary patterns, macronutrients, and food groups with HbA1c in a model adjusted for relevant covariates and stratified by diabetes status. Results: Three dietary patterns were identified: “fruits, veggies, meats, cereal”, “baked desserts” and “convenience foods and alcohol” patterns. At baseline, a higher intake of the “baked dessert” pattern was significantly associated with higher HbA1c in T1D at baseline as well at year 6 of the study when adjusted for age, sex, BMI, total calories, and diabetes duration. No such associations were observed in the case of non-diabetic controls. Dietary saturated fats and animal fats were also positively associated with HbA1c in adults with T1D at baseline and/or at year 6. Conclusions: The habitual intake of a dietary pattern that is characterized by an increased intake of added sugar and saturated fats, such as in baked desserts, may increase risks of poor glycemic control in T1D.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA
- Correspondence: ; Tel.: +1-702-895-4576
| | - Amy C. Alman
- College of Public Health, University of South Florida, Tampa, FL 33612, USA;
| | - Janet K. Snell-Bergeon
- Barbara Davis Center for Childhood Diabetes, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
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Abstract
OBJECTIVE To assess the association between dietary patterns and glycaemic control among Qatari adults with type 2 diabetes (T2DM). DESIGN Cross-sectional analysis using data from the Qatar Biobank Study. Poor glycaemic control was defined as HbA1c ≥7·0 %. Dietary patterns were constructed using factor analysis based on habitual food intake assessed by a FFQ. Medication use was based on self-report. Multivariable logistic regression was used to assess the association. SETTING Qatar. PARTICIPANTS Adults aged ≥18 years (n 1000) with known diabetes. RESULT The mean age of the participants was 52·3 (sd 11·5) years. Overall, the prevalence of poor glycaemic control was 57·6 %, and 27·7 % of the participants were insulin users. Three dietary patterns were identified. The modern dietary pattern (high intake of fast food, croissants, white bread and cheese) was inversely associated with poor glycaemic control. The sd increments of the modern pattern had OR for poor glycaemic control of 0·86 (95 % CI 0·68, 1·08) in men and 0·76 (95 % CI 0·61, 0·95) in women. There was a significant interaction between the modern pattern and diabetes medication in men but not in women. In men without diabetes medication, the modern pattern was positively associated with poor glycaemic control with an OR of 2·35 (95 % CI 1·13, 4·87). CONCLUSIONS Male diabetes patients took medication to control diabetes but ate more unhealthy food. In men who were not taking diabetes medication, modern dietary pattern was associated with poor glycaemic control. Promoting healthy eating should be encouraged especially among those under diabetes medication.
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