Associations between eating habits and glycemic control and obesity in Japanese workers with type 2 diabetes mellitus

Abstract

Purpose

To investigate the impact of poor eating habits on glycemic and metabolic control, we analyzed the associations between eating behaviors and HbA1c and body mass index (BMI) in Japanese workers with type 2 diabetes mellitus (T2DM).

Subjects and methods

The Japan Medical Data Center database of workers’ medical health insurance claims was used to identify individuals with T2DM who were receiving antidiabetic medication between April 2012 and March 2015 (the primary analysis population). The database included routine medical check-up results and responses to questions on lifestyle and eating habits. Using these, we retrospectively analyzed the associations between the individuals’ eating habits and their HbA1c levels and BMIs.

Results

In total, 31,722 individuals were included in the primary analysis. The mean values of HbA1c and BMI were 7.27% and 26.29 kg/m², respectively; these tended to be higher among the younger population. Approximately 36% of the individuals regularly ate supper within 2 hours of bedtime, 14.5% regularly consumed late-night snacks, and 13.4% regularly skipped breakfast. Each of these eating habits correlated significantly with higher HbA1c and BMI. In addition, the population with two or all three of these poor dietary habits showed the highest association with HbA1c ≥7.0% and BMI ≥25 kg/m². Approximately 38% of workers ate fast. Fast eating was significantly associated with BMI ≥25 kg/m² but not with HbA1c ≥7.0%.

Conclusion

Poor eating habits were significantly associated with poor glycemic and body weight control in Japanese workers with T2DM. Improved eating habits may help with glycemic and body weight management.

Keywords:

• type 2 diabetes
• workers
• eating habits
• glycemic control
• obesity

Supplementary material

Figure S1 Time course changes in (A) Prescription of anti-diabetic agents, (B) HbA1c, and (C) BMI in workers with T2DM.

Note: Data in graphs (B) and (C) are means ± standard deviation.
Abbreviations: BMI, body mass index; DPP-4, dipeptidyl peptidase-4; GLP-1, glucagon-like peptide-1; HbA1c, glycated hemoglobin; SGLT2. sodium-glucose co-transporter-2.

Figure S2 Sampling design.

Note: (1) Workers were defined as insured members of health insurance associations between 2009 and 2015; (2) T2DM was identified by a disease classification code of E11 or E14 in the International Classification of Diseases and antihyperglycemic agents include those with the following Anatomical Therapeutic Chemical classification system sub-code (A10C, A10H, A10J, A10K, A10L, A10M, A10N, A10P, A10S); (3) The data set of T2DM workers include medical check-up data including both HbA1c and BMI values; (4) Primary analysis set included workers with T2DM with a latest medical check-up record between 2012 and 2015.
Abbreviation: T2DM, type 2 diabetes mellitus.

Acknowledgments

The authors would like to express gratitude to the following co-workers: Hiroaki Matsuda and Takumi Tajima from Mitsubishi Tanabe Pharma Corporation, Chie Ito, Satoshi Kusakabe, and Rie Nishikino from the JMDC for valuable advice of the study and conducting the data analysis, and Akira Saito, PhD (International Medical Translation Service, Inc.), for providing medical writing support funded by Mitsubishi Tanabe Pharma Corporation.

Author contributions

All authors contributed toward the study design, data analysis, drafting and revising the paper and agree to be accountable for all aspects of the work.

Disclosure

All authors are employees of Mitsubishi Tanabe Pharma Corporation, Japan. The authors report no other conflicts of interest in this work.