Khawar Rahman Dania, Khan Muhammad Irshad, Ikram Wardah, Mohsin Raza Mohammed
Department of Acute Medicine, Ealing Hospital, London, GBR.
Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, PAK.
Cureus. 2025 Jul 10;17(7):e87680. doi: 10.7759/cureus.87680. eCollection 2025 Jul.
Poor glycemic control remains a major challenge in managing type 2 diabetes mellitus (T2DM) in Pakistan, increasing the risk of complications. Dietary habits are a key modifiable factor influencing glycemic outcomes, yet evidence specific to the Pakistani population remains limited.
To evaluate the association between dietary habits and glycemic control among patients with T2DM attending a tertiary care hospital in Khyber Pakhtunkhwa, Pakistan, and to provide culturally and economically relevant insights to inform dietary recommendations.
This cross-sectional study was conducted at the Department of Endocrinology, Khyber Teaching Hospital, Peshawar, over 12 months. A total of 177 adults with T2DM were recruited using consecutive non-probability sampling. Dietary patterns were assessed using a culturally adapted, structured Food Frequency Questionnaire, and glycemic control was determined by glycated hemoglobin (HbA1c), with <7% considered good control. Associations between dietary variables and glycemic control were analyzed using Chi-square tests, t-tests/ANOVA, and multivariate logistic regression adjusting for potential confounders.
Among the 177 participants (mean age 54 ± 10.6 years; 55% female), 118 (66.7%) had poor glycemic control. High sugar intake (more than two servings/day) was significantly associated with higher mean HbA1c (8.6 ± 1.7%) compared to low sugar intake (less than one serving/day; 7.5 ± 1.1%, p = 0.011). Inadequate fiber intake (less than five servings/day) was linked to higher HbA1c (8.3 ± 1.5%) than adequate fiber intake (7.4 ± 1.2%, p = 0.004). Participants consuming two or fewer meals/day had the highest HbA1c (8.7 ± 1.5%), compared to those eating three meals/day (8.0 ± 1.4%) or more than three meals/day (7.8 ± 1.3%, p = 0.027). Multivariate analysis confirmed high sugar intake (adjusted odds ratio (AOR) = 2.67; 95% CI: 1.39-5.12), inadequate fiber intake (AOR = 2.45; 95% CI: 1.19-5.02), and low meal frequency (AOR = 2.21; 95% CI: 1.02-4.79) as independent predictors of poor glycemic control, after adjusting for age, gender, BMI, diabetes duration, and treatment regimen.
High sugar consumption, inadequate fiber intake, and infrequent meals were significantly associated with higher HbA1c and poor glycemic control in this cohort of Pakistani T2DM patients. These findings underscore the importance of culturally sensitive dietary counseling and targeted interventions to improve glycemic outcomes in this population.
在巴基斯坦，血糖控制不佳仍然是2型糖尿病（T2DM）管理中的一项重大挑战，这增加了并发症的风险。饮食习惯是影响血糖结果的一个关键可改变因素，但针对巴基斯坦人群的具体证据仍然有限。
评估在巴基斯坦开伯尔-普赫图赫瓦省一家三级护理医院就诊的T2DM患者的饮食习惯与血糖控制之间的关联，并提供与文化和经济相关的见解，以为饮食建议提供参考。
这项横断面研究在白沙瓦开伯尔教学医院内分泌科进行，为期12个月。使用连续非概率抽样法招募了177名成年T2DM患者。使用经过文化调整的结构化食物频率问卷评估饮食模式，通过糖化血红蛋白（HbA1c）确定血糖控制情况，HbA1c<7%被认为是良好控制。使用卡方检验、t检验/方差分析以及对潜在混杂因素进行调整的多因素逻辑回归分析饮食变量与血糖控制之间的关联。
在177名参与者中（平均年龄54±10.6岁；55%为女性），118名（66.7%）血糖控制不佳。与低糖摄入（每天少于一份；7.5±1.1%）相比，高糖摄入（每天超过两份）与更高的平均HbA1c（8.6±1.7%）显著相关（p=0.011）。纤维摄入不足（每天少于五份）与较高的HbA1c（8.3±1.5%）相关，而纤维摄入充足者为（7.4±1.2%，p=0.004）。每天进餐两次或更少的参与者HbA1c最高（8.7±1.5%），而每天吃三餐的参与者为（8.0±1.4%），每天进餐超过三餐的参与者为（7.8±1.3%，p=0.027）。多因素分析证实，在调整年龄、性别、体重指数、糖尿病病程和治疗方案后，高糖摄入（调整后的优势比（AOR）=2.67；95%置信区间：1.39-5.12）、纤维摄入不足（AOR=2.45；95%置信区间：1.19-5.02）和进餐频率低（AOR=2.21；95%置信区间：1.02-4.79）是血糖控制不佳的独立预测因素。
在这组巴基斯坦T2DM患者中，高糖消耗、纤维摄入不足和进餐不频繁与较高的HbA1c和血糖控制不佳显著相关。这些发现强调了具有文化敏感性的饮食咨询和针对性干预措施对于改善该人群血糖结果的重要性。
