Association between diet quality scores, adiposity, glycemic status and nutritional biomarkers among Indian population with type 2 diabetes mellitus: A cross-sectional study

Background: Unhealthy dietary scores have been associated with increased risk of Type 2 Diabetes mellitus, which have a significant impact on affected individuals and healthcare services. However, there is lack of published evidence on quality of diet in type 2 diabetic subjects. Therefore, we aimed to assess dietary pattern scores and their relationship with adiposity, glycemic profile, lipid parameters and nutritional biomarkers in T2DM patients. Methods: We included T2DM patients (n = 203) with age group ranging from 30-70 years. All patients were interviewed for their dietary patterns through a derivative questionnaire of UK Diabetes and Diet Questionnaire (UKDDQ). Patient information including socio-demographic and anthropometric details were obtained. All biochemical parameters were estimated and recorded. The SPSS ver. 21 was used to perform statistical analysis. Results: The study included 48.8% males and 51.2% females with mean age of 53.92 +/- 10.56 years. The mean values of diet scores ranged from healthiest [1.02 +/- 0.17(CI = 1.00 to 1.04)] to least healthy [2.65 +/- 0.71(CI = 2.55 to 2.74)] respectively. Majority of patients (n = 153) were reported to have a habit of skipping breakfast routinely within 2 h after waking. However, 162 patients were consuming the unnecessary food items between the regular meals. While increasing in diet mean scores i.e. moving from lower quintile Q1(21.86 +/- 1.23) to higher quintile Q5(28.94 +/- 2.24), a variable relationship was found. The post prandial (PP2)(r = 0.233), fasting blood glucose (FBG) (r = 0.183), HbA1c(r = 0.253) and body mass index (BMI) (r = 0.139) shown a direct association whereas zinc(r =-0.116), vitamin D(r =-0.185) and Albumin (r =-0.043) were inversely correlated between the quintiles. Conclusions: Increasing dietary scores are supposed to have a provoking effect on disease condition resulting into worse outcomes at higher scores. The findings from nutritional biomarkers suggested that deficiently found nutrients must be supplemented as a part of therapy to enhance the treatment benefits.