Adherence to a Mediterranean diet and glycaemic control in Type 2 diabetes mellitus

Aims Mediterranean-type diets reduce the risk of Type 2 diabetes. Whether a Mediterranean-type diet improves glycaemic control in diabetes remains unknown. Methods Weconducted a cross-sectional analysis in 901 outpatientswith Type 2 diabetes attending diabetes clinics located in Campania County, South Italy. We explored the relation between glycated haemoglobin (HbA1c), measured centrally, selfmeasured pre- and postprandial glucose levels and consumption of a Mediterranean-type diet. Adherence to a Mediterraneantype diet was assessed by a 9-point scale that incorporated the salient characteristics of this diet (range of scores, 0–9, with higher scores indicating greater adherence). The study was conducted from 2001 to 2007. Results Diabetic patients with the highest scores (6–9) had lower body mass index and waist circumferences, a lower prevalence of the metabolic syndrome and lower HbA1c and post-meal glucose levels than diabetic patients with the lowest scores (0–3). In multivariate analysis,meanHbA1c and 2-h post-meal glucose concentrations were significantly lower in diabetic patients with high adherence to a Mediterranean-type diet than those with low adherence [difference: HbA1c 0.9%, 95% confidence intervals (CI) 0.5–1.2%, P < 0.001; 2-h glucose 2.2 mmol ⁄ l, 95% CI 0.8–2.9 mmol⁄ l, P < 0.001]. Conclusions In Type 2 diabetes, greater adherence to a Mediterranean-type diet is associated with lower HbA1c and postprandial glucose levels. Diabet. Med. 26, 900–907 (2009) Keywords diet, glycaemic control, HbA1c, postprandial glucose, Type 2 diabetes Abbreviations BMI, body mass index; BMR, basal metabolic rate; CAPRI, Campanian Postprandial Hyperglycemia Study; HbA1c, glycated haemoglobin; HDL, high-density lipoprotein; MUFA, monounsaturated fatty acid; WHR, waist– hip ratio