The Effects of Macronutrient Intake on the Risk of Pre-Diabetes in First- Degree Relatives of Patients With Type 2 Diabetes



Yazdani A^{1, 2} ; Mansourian M^{1, 2} ; Faghihimani E^{3, 4} ; Zareh M^{3, 4} ; Amini M^{3, 4} Show Affiliations
Source: Journal of Isfahan Medical School Published:2014

Abstract

Background: Previous studies showed that pre-diabetes often occurs prior to the incidence of type 2 diabetes. Accordingly, lifestyle modification has been suggested to prevent or delay the development of diabetes. The purpose of this study was to identify the impact of macronutrients consumption on recurrent events of pre-diabetes. Methods: This historical cohort study was performed for 9 years on first-degree relatives of patients with type 2 diabetes attending to Isfahan endocrine and metabolism research center, Iran. The attendees completed laboratory tests including standard 75 g 2-hour current oral glucose tolerance test (OGTT). The outcome variables were the recurrence of a pre-diabetes event during follow-up and the assessed explanatory variables included protein, fat and carbohydrates intake, and a broad set of potential confounding variables were age categories, sex, overweight (body mas index or BMI), large waist-to-hip ratio (WHR), high-density lipoprotein (HDL), triglycerides, total cholesterol, high blood pressure, and low fiber intake. We considered the shared gamma frailty model to evaluate the association between recurrent pre-diabetes and explanatory variables. The R-software (version 2.15.2) was used to fit the models. Findings: Individuals with greater carbohydrate had a significantly higher hazard of recurrent prediabetes (hazard ratio = 1.04), adjusted by other variables. The hazards of recurrent pre-diabetes for individuals with fat intake of 25-35 unit were 1.52 higher than individuals with fat intake of lower than 25 unit; and for individuals with fat intake of more than 35 unit, hazards were 2.22 higher than individuals with fat intake of lower than 25 unit. Individuals with greater protein had a significantly higher hazard of recurrent pre-diabetes (hazard ratio = 1.05), adjusted by other variables. Conclusion: Macronutrient consumption can affect the metabolism of fat and glucose and cause changes in insulin resistance. The results of this study showed that macronutrients are effective in controlling diabetes. Further studies are recommended to achieve more accurate results. © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved.