Association of diabetes diagnosis with dietary changes and weight reduction

ABSTRACT

Background: Lifestyle modifications are associated with better outcomes for patients with diabetes. Patients’ awareness of having diabetes may promote lifestyle changes, but there is limited evidence to support this assertion. This study examined whether a report of physician-diagnosed diabetes is associated with dietary changes and efforts to lose weight.

Methods: Cross-sectional comparison of individuals with and without diabetes or prediabetes diagnosis, matched on glycosylated hemoglobin (HbA1c) level, socio-demographic characteristics, and health status using propensity-score matching analysis. Non-pregnant US adult participants (aged 20 and older with an HbA1c level between 5.7% and 7.5%) in the 1999–2014 National Health and Nutrition Examination Survey were included (N = 10,781).

Results: Compared with matched controls who did not report having diabetes or prediabetes (N = 1,769), persons with a diagnosis of diabetes or prediabetes (N = 1,769) reported less sugar consumption (14.9 grams [95% CI: 8.9 to 21.0]); less carbohydrate consumption (11.6 grams [95% CI: 1.7 to 21.5]); higher rates of trying to lose weight (12.3 percentage points [95% CI: 5.3 to 19.2]); and a greater one-year weight reduction (4.8 ounces [95% CI: 3.3 to 6.4]).

Conclusions: Awareness of a diagnosis of diabetes or prediabetes from a health profession is associated with the uptake of recommended life-style modifications.

KEYWORDS:

• Diabetes diagnosis
• health-promoting behavior
• dietary changes
• weight management
• propensity score matching

Declaration of interest

The authors have no relevant affiliations or financial interest with any organization or entity that would pose a conflict of interest with the subject matter discussed in this manuscript.

Notes

1. We excluded patients who are taking insulin because their current HbA1c level could be lowered as a result of diabetes management (including insulin intake). Indeed, adding those patents to the analysis did not change the main results in any meaningful way (the results are available upon request).

Additional information

Funding

This paper was not funded.

Notes on contributors

Amal N. Trivedi

Amal N. Trivedi was involved in the conception and design. Daeho Kim and Kanghyock Koh were involved in analysis and interpretation of the data. Shailender Swaminathan was involved in drafting of the paper. All authors revised the paper critically for intellectual content. All authors approved the version to be published; and agree to be accountable for all aspects of the work.