Plant-based diet lowers risks of microvascular complications in T2D

Higher scores in healthful dietary patterns can help reduce the risk of diabetic kidney disease (DKD), while healthful plant-based diet index (HPDI) is inversely associated with the risks of diabetic retinopathy (DR) and diabetic neuropathy (DN), a study has shown.

Overall, 6,119 participants with type 2 diabetes (T2D) from the UK Biobank were included in this prospective cohort study. The authors assessed dietary pattern scores based on 24-h dietary questionnaires and identified DKD, DR, and DN using electronic health records.

Multivariable-adjusted Cox models were used to calculate hazard ratios (HRs) and 95 percent confidence intervals (CIs). The authors conducted stratified analyses by age group, sex, obesity status, and various medical conditions and performed mediation analyses to assess the potential mediating role of 23 circulating biomarkers.

Higher dietary pattern scores correlated with a reduced DKD risk during a median follow-up of 9.9 years. HPDI showed the strongest association (HR for highest vs lowest quintile, 0.55, 95 percent CI, 0.43‒0.70) and remained the leading dietary pattern to show a robust relationship with DKD risk when compared with the same reference group.

Furthermore, only HPDI significantly correlated with reduced risks of DR (HR, 0.74, 95 percent CI, 0.58‒0.96) and DN (HR, 0.61, 95 percent CI, 0.39‒0.95) among the dietary patterns assessed. Notably, cystatin C and C-reactive protein primarily mediated these associations.

“These associations were mainly mediated through pathways relating to renal function and inflammation,” the authors said.