Trends, patterns, and determinants of dietary supplement use in patients with Type 2 Diabetes Melitus

This study examined 16-year trends in dietary supplement use and its associated sociodemographic and clinical characteristics among adults with type 2 diabetes (T2DM).

This study included adults with T2DM participating in the third (2006-2008, n = 1077), fourth (2009-2011, n = 1376), fifth (2012-2014, n = 1520), sixth (2015-2017, n = 1592), and seventh (2018-2022, n = 1554) examinations of the Tehran Lipid and Glucose Study (TLGS). Trends in supplement use and participant characteristics were described across phases, and logistic regression was used to identify predictors of any supplement use in the 2018-2022 examination.

Over 16 years, mean age increased from 57.3 to 62.0 years. Abdominal obesity (38.1% to 47.0%), hypertension (41.9% to 56.5%), and chronic kidney disease (23.1% to 38.2%) remained highly prevalent. Supplement use increased significantly from 8.9% in 2006-2008 to 23.9% in 2018-2022, driving by increases in thiamin (2.0% to 16.0%), folic acid (2.5% to 10.6%), cobalamin (1.6% to 8.5%), vitamin C (1.4% to 8.2%), vitamin E (1.9% to 8.7%), and zinc (0.3% to 3.8%), while calcium supplement use declined from 5.8% to 1.0%. Supplement use was more likely among women (OR = 1.63, 95% CI = 1.28-2.08) and individuals with good glycemic control (OR = 1.28, 95% CI = 1.01-1.62), while late middle-aged (OR = 0.41, 95% CI = 0.18-0.95), elderly adults (OR = 0.43, 95% CI = 0.18-0.97) and housewives (OR = 0.41, 95% CI = 0.23-0.72) had significantly lower odds.

These findings indicate a significant increase in dietary supplement use alongside persistent cardiometabolic comorbidities in adults with T2DM, with patterns varying by type of supplement, demographics, and clinical determinants.