Evaluating daily dietary glycemic load, glycemic index, and carbohydrate intake as potential predictors of diabetes remission in adults with type 2 diabetes

Abstract

There is growing evidence that type 2 diabetes remission can be achieved with non-surgical interventions. However, it remains unclear which factors are important predictors of diabetes remission. We conducted analyses on 304 individuals with type 2 diabetes in the REMIT trials to explore whether glycemic dietary indices are important independent predictors of diabetes remission. Diabetes remission was defined as glycemic levels returning to normal (HbA1c < 6.5%) without the need for glucose-lowering medications for at least 3 months. Daily dietary glycemic load (GL, primary research question), glycemic index (GI), and carbohydrate intake (g) at 12 weeks or as a change from baseline to 12 weeks, were not associated with diabetes remission. Higher daily carbohydrate intake (% of daily energy intake) at 12 weeks was associated with lower odds of diabetes remission when comparing the highest quartile to the lowest quartile. The adjusted odds ratio (OR) of diabetes remission when comparing the highest quartile to the lowest was 0.289 (95% CI 0.124-0.673, p = 0.004). The change in daily carbohydrate intake (% of daily energy intake) from baseline to 12 weeks was also associated with diabetes remission, after adjusting for the baseline value. The adjusted OR of diabetes remission per 5% increase in daily carbohydrate intake from baseline to 12 weeks was 0.750 (95% CI 0.587-0.956, p = 0.020). In summary, daily dietary GL, GI, and carbohydrate intake (g) were not statistically significant predictors of diabetes remission in our study. However, higher daily carbohydrate intake (% of daily energy intake) at 12 weeks and increasing daily carbohydrate intake (% of daily energy intake) from baseline to 12 weeks both predicted lower odds of diabetes remission.