Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort
Background: In real-world settings, whether diet and medication are used as complements for glycemic management in type 2 diabetes (T2D) remains unclear. This study assessed the relationship between diet quality and intensity of glucose-lowering medication among adults with T2D. Methods: This cross-...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | CJC Open |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589790X23002597 |
| _version_ | 1797345902056177664 |
|---|---|
| author | Clémence Desjardins, RD, MSc Lise Leblay, PhD(c) Amélie Bélanger, RD, MSc Mathieu Filiatrault, PharmD(c) Olivier Barbier, PhD Line Guénette, BPharm, PhD Jacinthe Leclerc, PhD Jean Lefebvre, BPharm, PhD Arsène Zongo, BPharm, PhD Jean-Philippe Drouin-Chartier, RD, PhD |
| author_facet | Clémence Desjardins, RD, MSc Lise Leblay, PhD(c) Amélie Bélanger, RD, MSc Mathieu Filiatrault, PharmD(c) Olivier Barbier, PhD Line Guénette, BPharm, PhD Jacinthe Leclerc, PhD Jean Lefebvre, BPharm, PhD Arsène Zongo, BPharm, PhD Jean-Philippe Drouin-Chartier, RD, PhD |
| author_sort | Clémence Desjardins, RD, MSc |
| collection | DOAJ |
| description | Background: In real-world settings, whether diet and medication are used as complements for glycemic management in type 2 diabetes (T2D) remains unclear. This study assessed the relationship between diet quality and intensity of glucose-lowering medication among adults with T2D. Methods: This cross-sectional study included 352 adults with T2D from the CARTaGENE Québec population-based cohort. Diet quality was assessed using the Healthful Plant-Based Diet Index (hPDI). Glucose-lowering medication intensity was graded according to self-reported information on the type and number of drugs: no medication; oral monotherapy; oral polytherapy; and insulin with and without oral medication. In the subsample of 239 individuals who reported the medication dosages, intensity was also graded using the Medication Effect Score (MES). Results: In multivariable-adjusted models, we found no evidence of a relationship between the hPDI and medication intensity, assessed using the categorical approach (Pbetween-group = 0.25) or the MES (P = 0.43). However, the hPDI was inversely associated with the MES among men < 50 years of age and women < 60 years (β1-point MES = –2.24 [95% confidence interval, –4.46, –0.02] hPDI points), but not among older individuals (β = –0.03 [–1.28, 1.21] hPDI points). Evidence of a nonsignificant inverse relationship between the hPDI and HbA1c was observed (β10-point hPDI = –0.23% [–0.63, 0.17]), whereas a positive and significant association between the MES and hemoglobin (Hb)A1c was found (β1-point MES = 0.30% [0.10, 0.51]). Conclusions: In this cohort of adults with T2D, there was an overall lack of complementarity between diet quality and intensity of glucose-lowering medication. The issue was particularly important among younger adults for whom diet quality was inversely associated with intensity of medication. Résumé: Introduction: Il n'a jamais été étudié, en contexte réel, si la qualité de l'alimentation et la médication sont utilisées de façon complémentaire dans la gestion de la glycémie chez des personnes avec le diabète de type 2 (DT2). La présente a évalué la relation entre la qualité de l'alimentation et l’intensité de la médication hypoglycémiante chez des adultes avec DT2. Méthodes: Cette étude transversale portait sur 352 adultes avec DT2 participant à la cohorte populationnelle québécoise CARTaGENE. Nous avons évalué la qualité du régime à l’aide du Healthful Plant-based Diet Index (hPDI, soit l’indice d’un régime alimentaire à base de plantes). Nous avons évalué l’intensité des médicaments hypoglycémiants à partir des renseignements fournis sur le type et le nombre de médicaments : aucun médicament, monothérapie orale, polythérapie orale, insuline avec ou sans médicaments par voie orale. Dans le sous-échantillon de 239 individus qui ont mentionné les posologies de médicaments, nous avons aussi évalué l’intensité au moyen du Medication Effect Score (MES). Résultats: Dans les modèles multivariés, nous n’avons observé aucune évidence de relation entre le hPDI et l’intensité des médicaments au moyen de l’approche catégorielle (Pentre les groupes = 0,25) ou du MES (P = 0,43). Toutefois, le hPDI était inversement associé au MES chez les hommes < 50 ans et chez les femmes < 60 ans (βMES 1 point = –2,24 [intervalle de confiance à 95 %, –4,46, –0,02] points hPDI), mais non chez les personnes plus âgées (β = –0,03 [–1,28, 1,21] point hPDI). Nous avons observé une relation inverse non significative entre le hPDI et l’hémoglobine (Hb)A1c (βhPDI 10 points = –0,23 % [–0,63, 0,17]) et une association positive et significative entre le MES et l’HbA1c (βMES 1 point = 0,30 % [0,10, 0,51]). Conclusions: Au sein de cette cohorte d’adultes avec DT2, nous avons constaté une absence globale de complémentarité entre la qualité de l'alimentation et l’intensité des médicaments hypoglycémiants. Cet enjeu était d’autant plus important chez les personnes plus jeunes pour lesquels la qualité du régime était inversement associée à l’intensité des médicaments. |
| first_indexed | 2024-03-08T11:25:32Z |
| format | Article |
| id | doaj.art-28a4d2cf33584ef0a1000fb7ef1a5f8b |
| institution | Directory Open Access Journal |
| issn | 2589-790X |
| language | English |
| last_indexed | 2024-03-08T11:25:32Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | CJC Open |
| spelling | doaj.art-28a4d2cf33584ef0a1000fb7ef1a5f8b2024-01-26T05:34:25ZengElsevierCJC Open2589-790X2024-01-01612029Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE CohortClémence Desjardins, RD, MSc0Lise Leblay, PhD(c)1Amélie Bélanger, RD, MSc2Mathieu Filiatrault, PharmD(c)3Olivier Barbier, PhD4Line Guénette, BPharm, PhD5Jacinthe Leclerc, PhD6Jean Lefebvre, BPharm, PhD7Arsène Zongo, BPharm, PhD8Jean-Philippe Drouin-Chartier, RD, PhD9Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada; Faculty of Pharmacy, Laval University, Québec City, Québec, CanadaNutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada; Faculty of Pharmacy, Laval University, Québec City, Québec, CanadaNutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada; Faculty of Pharmacy, Laval University, Québec City, Québec, CanadaFaculty of Pharmacy, Laval University, Québec City, Québec, CanadaNutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada; Faculty of Pharmacy, Laval University, Québec City, Québec, Canada; CHU de Québec-Université Laval Research Center, Québec City, Québec, CanadaFaculty of Pharmacy, Laval University, Québec City, Québec, Canada; CHU de Québec-Université Laval Research Center, Québec City, Québec, CanadaFaculty of Pharmacy, Laval University, Québec City, Québec, CanadaFaculty of Pharmacy, Laval University, Québec City, Québec, CanadaFaculty of Pharmacy, Laval University, Québec City, Québec, Canada; CHU de Québec-Université Laval Research Center, Québec City, Québec, CanadaNutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Québec, Canada; Faculty of Pharmacy, Laval University, Québec City, Québec, Canada; Corresponding author: Dr Jean-Philippe Drouin-Chartier, NUTRISS, INAF, Laval University, Pavillon des Services, 2440 Boulevard Hochelaga, Québec City, Québec G1V 0A6, Canada. Tel.: +1-418-656-2131.Background: In real-world settings, whether diet and medication are used as complements for glycemic management in type 2 diabetes (T2D) remains unclear. This study assessed the relationship between diet quality and intensity of glucose-lowering medication among adults with T2D. Methods: This cross-sectional study included 352 adults with T2D from the CARTaGENE Québec population-based cohort. Diet quality was assessed using the Healthful Plant-Based Diet Index (hPDI). Glucose-lowering medication intensity was graded according to self-reported information on the type and number of drugs: no medication; oral monotherapy; oral polytherapy; and insulin with and without oral medication. In the subsample of 239 individuals who reported the medication dosages, intensity was also graded using the Medication Effect Score (MES). Results: In multivariable-adjusted models, we found no evidence of a relationship between the hPDI and medication intensity, assessed using the categorical approach (Pbetween-group = 0.25) or the MES (P = 0.43). However, the hPDI was inversely associated with the MES among men < 50 years of age and women < 60 years (β1-point MES = –2.24 [95% confidence interval, –4.46, –0.02] hPDI points), but not among older individuals (β = –0.03 [–1.28, 1.21] hPDI points). Evidence of a nonsignificant inverse relationship between the hPDI and HbA1c was observed (β10-point hPDI = –0.23% [–0.63, 0.17]), whereas a positive and significant association between the MES and hemoglobin (Hb)A1c was found (β1-point MES = 0.30% [0.10, 0.51]). Conclusions: In this cohort of adults with T2D, there was an overall lack of complementarity between diet quality and intensity of glucose-lowering medication. The issue was particularly important among younger adults for whom diet quality was inversely associated with intensity of medication. Résumé: Introduction: Il n'a jamais été étudié, en contexte réel, si la qualité de l'alimentation et la médication sont utilisées de façon complémentaire dans la gestion de la glycémie chez des personnes avec le diabète de type 2 (DT2). La présente a évalué la relation entre la qualité de l'alimentation et l’intensité de la médication hypoglycémiante chez des adultes avec DT2. Méthodes: Cette étude transversale portait sur 352 adultes avec DT2 participant à la cohorte populationnelle québécoise CARTaGENE. Nous avons évalué la qualité du régime à l’aide du Healthful Plant-based Diet Index (hPDI, soit l’indice d’un régime alimentaire à base de plantes). Nous avons évalué l’intensité des médicaments hypoglycémiants à partir des renseignements fournis sur le type et le nombre de médicaments : aucun médicament, monothérapie orale, polythérapie orale, insuline avec ou sans médicaments par voie orale. Dans le sous-échantillon de 239 individus qui ont mentionné les posologies de médicaments, nous avons aussi évalué l’intensité au moyen du Medication Effect Score (MES). Résultats: Dans les modèles multivariés, nous n’avons observé aucune évidence de relation entre le hPDI et l’intensité des médicaments au moyen de l’approche catégorielle (Pentre les groupes = 0,25) ou du MES (P = 0,43). Toutefois, le hPDI était inversement associé au MES chez les hommes < 50 ans et chez les femmes < 60 ans (βMES 1 point = –2,24 [intervalle de confiance à 95 %, –4,46, –0,02] points hPDI), mais non chez les personnes plus âgées (β = –0,03 [–1,28, 1,21] point hPDI). Nous avons observé une relation inverse non significative entre le hPDI et l’hémoglobine (Hb)A1c (βhPDI 10 points = –0,23 % [–0,63, 0,17]) et une association positive et significative entre le MES et l’HbA1c (βMES 1 point = 0,30 % [0,10, 0,51]). Conclusions: Au sein de cette cohorte d’adultes avec DT2, nous avons constaté une absence globale de complémentarité entre la qualité de l'alimentation et l’intensité des médicaments hypoglycémiants. Cet enjeu était d’autant plus important chez les personnes plus jeunes pour lesquels la qualité du régime était inversement associée à l’intensité des médicaments.http://www.sciencedirect.com/science/article/pii/S2589790X23002597 |
| spellingShingle | Clémence Desjardins, RD, MSc Lise Leblay, PhD(c) Amélie Bélanger, RD, MSc Mathieu Filiatrault, PharmD(c) Olivier Barbier, PhD Line Guénette, BPharm, PhD Jacinthe Leclerc, PhD Jean Lefebvre, BPharm, PhD Arsène Zongo, BPharm, PhD Jean-Philippe Drouin-Chartier, RD, PhD Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort CJC Open |
| title | Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort |
| title_full | Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort |
| title_fullStr | Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort |
| title_full_unstemmed | Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort |
| title_short | Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort |
| title_sort | relationship between diet quality and glucose lowering medication intensity among adults with type 2 diabetes results from the cartagene cohort |
| url | http://www.sciencedirect.com/science/article/pii/S2589790X23002597 |
| work_keys_str_mv | AT clemencedesjardinsrdmsc relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT liseleblayphdc relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT ameliebelangerrdmsc relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT mathieufiliatraultpharmdc relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT olivierbarbierphd relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT lineguenettebpharmphd relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT jacintheleclercphd relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT jeanlefebvrebpharmphd relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT arsenezongobpharmphd relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort AT jeanphilippedrouinchartierrdphd relationshipbetweendietqualityandglucoseloweringmedicationintensityamongadultswithtype2diabetesresultsfromthecartagenecohort |