Association of dietary acid-base load and diabetic sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A case-control study.

OBJECTIVES: The higher acid-forming potential of a diet, could be associated with diabetes. No study has been done to investigate the association between Dietary Acid Load (DAL) and polyneuropathy in patients with diabetes. This study aimed to examine the linkage between the DAL and Diabetic Sensory-motor Polyneuropathy (DSPN) in a case-control study. METHOD: This case-control study was performed at Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, in Kermanshah, Iran between April 2020 and August 2020. A total of 185 subjects with DSPN and 185 sex- and age-matched people in the control group (30-60 years old) participated in this study. Dietary intakes of all people were assessed using a validated food frequency questionnaire. DAL was evaluated through the Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP). Toronto clinical neuropathy score was applied to define DSPN. Anthropometrics data, and fasting blood glucose levels were measured. RESULTS: The Binary logistic regression was used to estimate the Odds Ratios (ORs) and 95% Confidence Intervals (95% CIs) of NEAP and PRAL in relation to DSPN. After adjustment for age, sex, energy people with higher DAL had increased odds for DSPN (ORPRAL = 3.0; 95%CI: 1.8-5.1; p-trend <0.001 and ORNEAP = 3.8; 95%CI: 2.2-6.5; p-trend <0.001). Additional adjustment for physical activity, education, smokers, and economic status strengthened the association (ORPRAL = 3.3; 95%CI:1.9-5.8; p-trend <0.001 and ORNEAP = 3.7; 95%CI: 2.2-6.5; p-trend<0.001). Finally, after additional adjustment for BMI in the full adjustment model, compared to people in the first tertile of DAL, participants in the third tertile had approximately 3.5 times significant greater odds for DSPN (ORPRAL = 3.3; 95%CI: 1.9-5.7; p-trend <0.001 and ORNEAP = 3.6; 95%CI: 2.2-6.2; p-trend<0.001). CONCLUSION: Patients with a higher acidic diet had greater odds for DSPN compared to people with lower DAL.

Association between Dietary Inflammatory Index Scores and Diabetes Sensorimotor Polyneuropathy in Patients with Type 2 Diabetes Mellitus: A Case-Control Study.

Background: Diabetes sensorimotor polyneuropathy (DSPN) is a common complication of diabetes. Diet has been previously related to DSPN. However, no studies have investigated the relationship between the inflammatory potential of the whole diet and DSPN. So, we aimed to examine the association between dietary inflammatory index (DII) and DSPN in Iranian adults. Methods: A total of 185 subjects with DSPN and 185 sex- and age-matched controls were selected in this case-control study. A 168-item validated food frequency questionnaire (FFQ) was used to assay dietary intakes. DII was calculated based on the developed formula. The Toronto clinical neuropathy score was applied to define DSPN. Binary logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of DII in relation to DSPN. Results: Mean values of age and BMI for all the participants were reported as 50.79 and 28.60, respectively. Also, the median (IQR) of DII for all the participants was estimated as -0.091 (-0.93, 1.07). Our findings suggest that participants in the highest quartile of the DII had higher odds of DSPN (OR = 1.76; 95% CI: 1.03, 3.36) (p-trend = 0.01) compared to subjects in the lowest quartile of DII scores after adjustment for age and sex. Additionally, a strong association was observed after adjusting for energy intake, physical activity, education, smoking status, economic status, marital status, job, BMI, and WC in model 2 (OR = 2.23, 95% CI = 1.13-4.39) (p-trend = 0.0048). Conclusion: Higher DII score was associated with an increased risk of DSPN. Therefore, it is possible that a diet rich in anti-inflammatory nutrients and foods could improve and prevent DSPN.