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Awareness of Glycemic Status Changes Macronutrient Intake

Although those diagnosed with diabetes consumed more protein and less sugar, all individuals consumed less fiber and more saturated fat than recommended….

After a diabetes diagnosis, individuals are recommended to see a registered dietitian (RD). However, national data indicate that only half ever receive some type of diabetes education and fewer see a registered dietitian. The primary prevention for individuals at a high risk for diabetes is diet and exercise. This study investigated whether nutrient intake differs in those aware of their glycemic status and those who are not in those with diagnosed diabetes who have visited a dietitian. Also, this study looked at the nutrient intake in those with diabetes compared to ADA recommendations.

The study used a morning fasting sample of the 2005-2010 National Health and Nutrition Examination Survey, a total of 3,725 nonpregnant adults with diabetes or prediabetes, and >20 years of age. Individuals who were unaware of diabetes were defined by fasting plasma glucose (FPG) >126 mg/dL or HbA1c >6.5%, and FPG 100-125 mg/dL or HbA1c of 5.7-6.4% in those with prediabetes. Individuals were assessed for the total calories, sugar, carbohydrates, fiber, protein, fat, and total cholesterol.

Men diagnosed with diabetes consumed less sugar (86.8 vs 116.8g) and carbohydrates (235 vs 262g) but more protein (92.3 vs 89.7g) than those with undiagnosed diabetes. The results were similar with women, less sugar (79.1 vs 95.7) and more protein (67.4 vs 56.6g). No significant differences in macronutrient intake were found in awareness of prediabetes, but favorable in patients with diabetes. All individuals consumed on average less fiber intake and more saturated fat (>10% of total kcal) than the American Diabetes Association recommendation.

In conclusion, the knowledge of glycemic status may favorably affect some dietary patterns for patients with diabetes.

Practice Pearls:

  • There is no benefit observed with prediabetes awareness.
  • Nutrient education is important is patients who have been newly diagnosed to improve dietary modification and glycemic management.
  • ADA recommends physical activity and nutrition therapy as a prevention among people with diabetes.

Bardenheier B, Cogswell M, Gregg E, et al. “Does knowing one’s elevated glycemic status make a difference in macronutrient intake?” American Diabetes Association. September 9, 2014. “http://care.diabetesjournals.org/content/37/12/3143.full”