Study On The Relationship Of Dietary Status And Diabetes Mellitus In Community Residents

Objective: To investigate the dietary characteristics and main dietary patterns of community residents in the sample area,and to analyze the effects of dietary factors and non-dietary factors on diabetes and blood glucose control.Methods: Using the method of multi-stage random cluster sampling and combining the centralized survey and household survey,the subjects were investigated by questionnaire,diet survey,physical measurement and laboratory examination.Using exploratory factor analysis method,the original food group was included in the factor analysis model.The feature root >1 and variance cumulative contribution rate were used as the inclusion criteria for common factors.The main dietary patterns were determined by combining the gravel map and common factor interpretation variance.According to the dietary pattern factor score,it was divided into quartiles from high to low(Q1 indicates the least preference for this type of diet,and Q4 indicates the most preference for this type of diet).Multivariate logistic regression analysis was used to study the effects of different dietary patterns on the incidence of diabetes or blood glucose control.Test level ?=0.05.Results: 1.Basic information: 3203 community residents aged 18-85 were selected as the study subjects in 2015,among whom 2770 were non-diabetic,including 1139 males and 1631 females.Among the non-sick population,333 newly screened patients with diabetes were diagnosed,including 149 males and 184 females.Differences in age,area,BMI,physical activity,and hypertension between newly diagnosed and non-diabetic patients were statistically significant.2.Current status of diet: the problem of insufficient diet and excessive diet existed simultaneously in the investigated population.Such as potato intake is more,fish and shrimp,eggs intake is insufficient,fruits and vegetables,milk intake is low,edible oil intake is excessive,only meat and poultry,soy nuts food intake is appropriate.The dietary pattern of this group belongs to the Oriental dietary pattern which is mainly plant-based food and supplemented by animal food,but its fat energy supply reaches 42.1%,far exceeding the traditional Oriental diet.3.Dietary patterns to the influence of diabetes: using factor analysis method to analyze dietary patterns,there are 6 kinds of dietary patterns are established,These 6 dietary patterns are respectively edible oil and salt pattern,sweets and milk pattern,grain and potato meat and egg and fruit pattern,plant-based food patterns,soy vegetable and poultry pattern,fish and shrimp wine pattern,this explains 54.79% of dietary variation.Multivariate logistic regression was used to analyze the relationship between these 6 dietary patterns and diabetes.After adjusting for age,area of residence,BMI,high blood pressure,and alcohol consumption,the “plant-based” and “soy vegetable and poultry” dietary patterns were associated with diabetes risk in male residents.After adjusting for confounding factors such as age,BMI,high blood pressure,physical activity,smoking and alcohol consumption,the “sweets pattern” and “grain and potato meat and egg and fruit pattern” were associated with diabetes risk in female residents.4.Influence of dietary pattern on diabetic blood glucose control: dietary pattern analysis of diabetic patients was conducted by using factor analysis method,and 6 dietary patterns were established,explaining 58.12% of dietary variation.These 6 dietary patterns are respectively edible oil and salt pattern,vegetable and meat pickles pattern,egg and milk pickles pattern,soybean meat and poultry and wine pattern,aquatic fruit food pattern and sweets milk pattern.After further multivariate logistic regression analysis,adjusting for age,BMI,hypertension,alcohol consumption,smoking and other factors,the two dietary patterns of “edible oil and salt” and “egg and milk and pickles pattern” were correlated with the control of diabetes blood glucose.Conclusion: 1.The dietary structure of community residents in this region is not balanced,and the problems of insufficient diet and excessive diet coexist,which are shown as follows: excessive intake of edible oil,excessive intake of cereals and tubers,insufficient intake of fish,shrimp and eggs,and low intake of fruits,vegetables and milk.Only meat and poultry,soy and nuts food intake is moderate.The dietary pattern of this group belongs to the Oriental dietary pattern which is mainly plant food and supplemented by animal food,but its fat energy supply reaches 42.1%,far exceeding the traditional Oriental diet.2.Certain dietary patterns of residents in this area have an impact on the incidence of diabetes or diabetes blood glucose control.Among them,“Soy vegetable and poultry pattern”,“sweets pattern”,“edible oil and salt pattern” was a risk factor,“grain and potato meat and egg and fruit pattern”,“plant-based food patterns”,and “egg and milk pickles pattern” were protective factors. OBJECTIVE: To investigate the current status of dietary compliance and its influencing factors in community diabetes patients,and explore the key links of diabetes dietary compliance transformation,which would provide reference for the development of community dietary management strategies.Methods: A cluster sampling method was applied to investigate the dietary compliance,dietary belief,diabetes pain,social support status and glucose control status among diabetic patient through questionnaire survey and laboratory examination methods.The effects of demographics characteristics,diseases conditions,knowledge sources,and psychological factors on dietary compliance were analyzed by multiple linear regression methods with the test level ? of 0.05.Results: 1.332 subjects including 152 males(45.8%)and 180 females(54.2%)were investigated in this survey.The age ranged from 27 to 83 years old,with an average age of 65.02±8.73 years.The dietary compliance score of the investigated participants ranged from 12 to 40 points,and the average score was 29.23±4.50 points.Only 12.80% of patients reported by themselves that they completely implemented the requirements of diabetic diet,suggesting that most of patients had a poor compliance.In terms of glycemic control,23% of patients perceived by themselves that their glucose control were in the normal range,and those who felt unconscious or completely uncontrolled accounted for 75.9%.In addition,31.0% of patients had fasting blood glucose lower than 7.0 mmol/L,44.0% of patients had controlled Hb A1 c lower than 7.0 mmol/L,and 93.5% of patients had FINS value exceeded the normal reference,respectively.Overall,the glycemic control among diabetes patients was poor.2.It was shown by univariate analysis that health education,various dietary knowledge sources,self-perception of glycemic control,quality of life self-scoring,follow-up times,total dietary knowledge,dietary basics knowledge,GI basics knowledge,the knowledge of GI food,nutrition label knowledge,the total score of diet four factors belief,information resource trust,perceived importance,future results,stigma,total social support score,diabetes pain score,emotional pain,doctor-related pain,medical implementation pain,family and support pain were all closely related to diabetes diet compliance(P<0.01).Furthermore,multiple linear regression was applied by using the dietary compliance score as the dependent variable.The results indicated that eight variables including “the medical implementation painful”,“food self-efficacy”,“perceived importance”,“GI basic knowledge”,“friends and relatives support pain”,“sickness”,“community lecture” and “nutrition label knowledge” entered the regression equation finally with the adjustment coefficient R2 of 0.449.Conclusions: 1.Most of the enrolled diabetes patients had a poor dietary compliance.2.There was significant relationships between“the medical implementation painful”,“food self-efficacy”,“perceived importance”,“GI basic knowledge”,“friends and relatives support pain”,“sickness”,“community lecture” and “nutrition label knowledge” and dietary compliance in diabetic patients.ConclusionsThis study used a cross-sectional survey with a large sample size to explore the relationship between dietary characteristics with diabetes and the key aspects of dietary behavior change from the perspective of regional dietary characteristics and dietary behavior influencing factors.We found that: 1.The dietary pattern of the surveyed community population belonged to the oriental diet model characterized by excessive intake of plant fat.The lack of diet and over-meal status simultaneously existed,and there was a gap between the recommended balanced diet model.2.The dietary model should focus on the whole rather than only a certain food or nutrient,which would be more instructive for the improvement of residents' health.The trend toward a balanced diet recommended by the guidelines was conducive to the prevention and control of diabetes.It was urgent for studies to further explore the association between dietary patterns and diabetes prevention.3.Most of the enrolled diabetes patients had a poor dietary compliance,which was significant related with “the medical implementation painful”,“food self-efficacy”,“perceived importance”,“GI basic knowledge”,“friends and relatives support pain”,“sickness”,“community lecture” and “nutrition label knowledge”.It is necessary to strengthen the research about the influence of these factors on the compliance of diabetes diet,and pay attention to the transformation of existing results into the behavior of community patients,and effectively exert the effect of research results in the prevention and treatment of diabetes.