Title: Nutritional Status-Related Factors Contribute to Poor Glycemic Status in a Sample of Iraqi Patients with Type 2 Diabetes
Authors: Ali K Al-Hasnawi, Barakatun Nisak MY, AS Hazizi, Al-Razzouqi Rafi
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.51
DIDS : 08.2015-XXXXXXX
Abstract
Background: Type 2 diabetes mellitus (DM) is now posing the largest disease threat to Iraq’s health care services with majority of our patients were reported to have poor glycemic status. Role of nutrition therapy is important, however their nutritional status is not fully being addressed. Therefore, this study aimed to determine nutritional status-related factors and its contribution to glycemic status in a sample of Iraqi patients with Type 2 DM.
Methodology: A total of 170 diabetics (91 males, 79 females) aged 20 years and above (Mean + SD = 51.2 ± 10.2 years) from a selected Diabetic Centre in Teaching hospital in Iraq were recruited. Nutritional status characteristics which include anthropometric, biochemical, clinical and dietary intake data including dietary glycemic index (GI) and glycemic load (GL) were collected. Glycemic status was assessed using HbA1c level. Medical characteristic and other lifestyle behaviours including smoking status and physical activity level were also obtained.
Results: Subjects participated in the study were diagnosed with Type 2 DM between 5 and 10 years. Their mean HbA1c was 10.4 ± 1.6% with only 0.6% achieved the target treatment goal of HbA1c < 7%. Their mean BMI was 29.6 ± 4.0 kg/m2 with 89% of the subjects were either overweight or obese. Average energy intake of the subjects was 2032.7 ± 274.6 kcal/day with the proportion of macronutrients were in line with the professional bodies’ recommendation. Dietary GI and GL of the subjects were 59.7 ± 3.8 and 21.8 ± 3.8 respectively which generally higher as compared to the other Middle East studies. There were seven factors namely; Subjects who were on diet alone (Beta=0.25, t = 3.949, p=0.0001); LDL level ( Beta=-0.331, t = 5.388, p = 0.0001); Dietary GL ( Beta = 0.162 , t = 2.714, p = 0.007); physical activity level ( Beta = -0.241 , t = -3.580, p = 0.0001); BMI ( Beta = 0.214 , t= 3.395, p = 0.001); Subjects who were on Sulfonylurea (Beta=-0.167, t = -2.615, p=0.01); total fiber (Beta = 0.133, t = -2.169, p = 0.032); were found to be the predictors which explained 45% of the variation (R2 = 0.45) in glycemic status.
Conclusions: Poor glycemic status, overweight and obesity were highly prevalent in a sample of Iraqi patients with type 2 DM. Subjects who were on diet alone, high LDL level, high dietary GL intake, lack of physical activity, high BMI, subjects who were not on Sulfonylurea drug and had high total fibre were the factors contributed to poor glycemic status. Future studies should consider incorporating these components into the framework of nutrition-related intervention to Iraqi type 2 DM.
Key words: Nutritional status, Glycemic Index, Glycemic Load, Iraqi Type 2 Diabetes Mellitus.
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