Journal of Diabetes Investigation (Mar 2019)

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

  • Tadashi Yamakawa,
  • Rika Sakamoto,
  • Kenichiro Takahashi,
  • Jun Suzuki,
  • Minori Matuura‐Shinoda,
  • Mayumi Takahashi,
  • Erina Shigematsu,
  • Shunichi Tanaka,
  • Mizuki Kaneshiro,
  • Taro Asakura,
  • Takehiro Kawata,
  • Yoshihiko Yamada,
  • Uru Nezu Osada,
  • Tetsuo Isozaki,
  • Atsushi Takahashi,
  • Kazuaki Kadonosono,
  • Yasuo Terauchi

DOI
https://doi.org/10.1111/jdi.12903
Journal volume & issue
Vol. 10, no. 2
pp. 309 – 317

Abstract

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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 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.

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