Association Of Diet Quality With Hba1c And Illness Perception With Cardiovascular Risk Factors In Pre-Diabetes And At-Risk Of Pre-Diabetes Subjects Visiting Pusat Sejahtera, Usm
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Date
2019-12
Authors
Sania Siddiqui
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Publisher
Universiti Sains Malaysia
Abstract
Importance of dietary modification in prevention and delay of diabetes development is fully understood in literature. However, association between diet quality and HbA1c among pre-diabetic Malaysian population remains unclear. Illness perception may have found to be vary among individuals according to their pre-diabetes status. Its association with cardio vascular disease (CVD) risk factors among pre-diabetic patients was rarely studied. This study aims to identify and compare diet quality measured by Healthy Eating Index for Malaysian adults (HEI) among study population, and to identify association between HEI and HbA1c in distinct pre-diabetes states (i.e. pre-diabetes, at-risk of pre-diabetes, undiagnosed diabetes and healthy normoglycemic) .The secondary objective of this study was to identify and compare pre-diabetes related illness perception and its association with relevant CVD risk factors among pre-diabetic and at-risk of pre-diabetic subjects. Cross-sectional study was conducted between October 2018-March 2019 at Pusat Sejahtera USM. A total of 147 participants who met desired study criteria and volunteer to participate were recruited in this study. Data on diet, illness perception, anthropometric and on biochemical profile was measured by using Food frequency questionnaire and 24-hour recall form, Malaysian Brief illness perception questionnaire (MBIPQ) and standardized methods respectively. No significant difference and association between HEI composite score and HbA1c were observed upon analysis after adjusting for confounding factors among study groups. MBIPQ dimensions such as high personal control, and disease concern was significantly associated with lower HbA1c (r = - 0.424, p = 0.039), and diastolic blood pressure (r = - 0.433, p = 0.034) among pre-diabetic subjects. Similarly, stronger disease identity (experiencing more pre-diabetes related symptoms) and serious diseases consequences, was significantly associated with higher BMI (r = 0.297, p = 0.024), and systolic blood pressure (r = 0.287, p = 0.035) among at-risk of pre-diabetes subjects. On logistic regression, age and BMI was found to be directly associated with pre-diabetes, at-risk of pre-diabetes and undiagnosed diabetes (p<0.01), while triglyceride and female gender carried higher risk of undiagnosed diabetes (p<0.05). In conclusion, HEI score failed to predict HbA1c. This suggests that cross-sectionally, dietary habits may not be a strong risk factor for the development of pre-diabetes and diabetes. MBIPQ dimensions association with CVD risk factors suggests its implication in routine clinical setting. Age, BMI, triglycerides and female gender are key factors in predicting pre-diabetes, at-risk of pre-diabetes and undiagnosed diabetes that needed to be prioritized in managing pre-diabetes to achieve possible reversion.
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Pharmacy