Association of Dietary Patterns in Patients with Type 2 Diabetes and Microvascular Complications

Few studies have examined the relationship between dietary patterns and microvascular complications in patients with type 2 diabetes (T2D) to develop targeted management strategies.

To evaluate the association of dietary patterns and chronic microvascular complications in patients with T2D.

A nested case-control study of 5,154 patients with T2D diagnosed for <15 years, treated in primary care units in Mexico City and its metropolitan area. Microvascular complications (retinopathy, neuropathy, and nephropathy) were evaluated. Dietary data were obtained using a validated food frequency questionnaire. Principal component analysis identified dietary patterns, and multivariate analysis evaluated the association between microvascular complications and dietary patterns, adjusting for confounding variables.

A total of 3,423 patients were included, 59.1% of whom had microvascular complications. Six dietary patterns were identified, three of which were associated with microvascular complications. After adjusting for glycemic control (glycated hemoglobin <7 %), sex, blood pressure, body mass index, antihypertensive and lipid-lowering treatment, physical activity, and lipid profile, the highest quartile of the "Legumes and fats" pattern (OR: 2.191; 1.789-2.684; p <0.001) and the "Mexican food" pattern (OR: 1.231; 95% CI: 1.004-1.510; p = 0.046) were associated with an increased risk of microvascular complications. Conversely, high consumption of the "Healthy" pattern (OR: 0.81; 95% CI: 0.66-0.98; p = 0.037) was associated with a reduced risk.

The consumption of the "Legumes and fats" and "Mexican food" dietary patterns was associated with microvascular complications, while a higher consumption of the "Healthy" pattern was protective. These findings may be useful for providing specific nutritional recommendations in the management for patients with T2D.