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Exp Clin Endocrinol Diabetes 2016; 124(04): 230-238
DOI: 10.1055/s-0035-1569354
Article
© Georg Thieme Verlag KG Stuttgart · New York

The Impact of Dietary Factors on Glycemic Control, Insulin Sensitivity and Secretion in the First Years after Diagnosis of Diabetes

K. S. Weber
1   Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
,
A. E. Buyken
3   DONALD Study, IEL – Nutritional Epidemiology, University of Bonn, Germany
,
B. Nowotny
1   Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
,
K. Strassburger
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
4   Institute for Biometrics and Epidemiology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
,
M.-C. Simon
1   Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
,
G. Pacini
5   Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy
,
J. Szendroedi
1   Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
6   Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
,
K. Müssig
1   Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
6   Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
,
M. Roden
1   Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
2   German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
6   Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
,
for the GDS Group › Author Affiliations
Further Information

Publication History

received 24 October 2015
first decision 24 November 2015

accepted 03 December 2015

Publication Date:
28 April 2016 (online)

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Abstract

Background: Dietary factors play an important role in the prevention of diabetes mellitus. We tested the hypothesis that dietary factors related to diabetes onset also associate with its progression, i. e., early time courses of insulin sensitivity and secretion in both type 1 and type 2 diabetes.

Methods: In a prospective observational study, well-controlled recent-onset diabetes patients (n=127) underwent detailed metabolic characterization within the first year after diagnosis. A follow-up was conducted 2 years after the first examination. Insulin secretion and sensitivity were assessed by intravenous glucose tolerance testing. Baseline food consumption was analyzed by a food propensity questionnaire. Multivariate linear regression analysis was used to assess associations between consumption frequencies at baseline with metabolic changes during the first 2 years.

Results: Within the first 2 years, metabolic control did not change in patients with type 1 and type 2 diabetes on average. In type 1 diabetes, an increased consumption frequency of refined grains by one time/day at baseline associated with higher HbA1c by 0.60% (95% CI: 0.04; 1.16), P=0.04 after 2 years compared to baseline. In type 2 diabetes, an increased consumption frequency of meat/meat products by one time/day at baseline associated with lower beta-cell adaptation index (−7.25% (95% CI: −13.16; −0.93), P=0.03) after adjustment for age, sex, BMI, and changes of BMI and glucose-lowering medication.

Conclusion: Dietary factors associate with the initial course of diabetes. Reduced consumption of refined grains in type 1 diabetes and of meat products in type 2 diabetes may contribute to preservation of insulin secretion and sensitivity.

Key words

insulin resistance - beta-cell function - HbA1c - lifestyle

# The German Diabetes Study (GDS) Group consists of M. Roden (speaker), A.E. Buyken, J. Eckel, G. Geerling, H. Al-Hasani, C. Herder, A. Icks, J. Kotzka, O. Kuss, E. Lammert, J. Lundbom, K. Müssig, P. Nowotny, W. Rathmann, J. Szendrödi, D. Ziegler and their co-workers who are responsible for the design and performance of the GDS.


Supplementary Material

    Supplementary Tables S1 to S5 of this article can be found in internet as supplementary material with DOI http://dx.doi. org/10.1055/s-0036-1569354
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