The Effects of Dietary Nutrition Intake on Glycemic Variability in Type 1 Diabetes Mellitus Adults.

INTRODUCTION

Type 1 diabetes mellitus (T1DM) is characterized by an absolute deficiency of insulin and dependence on insulin therapy. Therefore, glycemic control and management are important for T1DM patients, particularly glycemic variability, which is associated with the development of diabetic complications. However, insufficient attention has been paid to the glycemic variability in T1DM patients so far. Our objective was to identify the effects of food intake on glycemic variability in T1DM patients.

METHODS

This was a single-center study that took place in the outpatient clinics of Peking Union Medical College Hospital. A total of 68 Chinese T1DM patients between June 2018 and June 2019 were enrolled. After the baseline demographic and clinical characteristics were evaluated, each participant underwent 14-day flash glucose monitoring (FGM). They recorded caloric intake of breakfast, lunch, and dinner at least 3 days/week using a "Menthol Health" app. After 2 weeks, we obtained the FGM data and did further data analysis. Baseline characteristics and glycemic variability index generated by FGM were compared among groups. A general linear model was used to compare data among groups after adjusting for potential confounding factors. The quantitative relationship between two continuous variables was explored by constructing a linear regression equation.

RESULTS

The results showed that the C-peptide level was independently correlated with the mean of daily differences (MODD) after adjusting for the possible confounders (β =  - 0.239, p = 0.046). The dietary nutrition intake had no effect on glycemic variability. However, the nutritional composition of carbohydrate, fat, and protein was an independent risk factor for time spent in hypoglycemia (TBR) post adjustment (β =  - 0.213, p = 0.054). However, there was no impact of daily total energy intake on glycemic variability index.

CONCLUSION

In our study, dietary nutrition intake had no effect on glycemic variability, but residual β-cell function was identified as an influencing factor for glycemic variability in T1DM adults. However, nutritional macronutrient composition played some roles in the occurrence of hypoglycemia. This might provide new evidence for the clinical glycemic control and management of T1DM in the Chinese population.