Diabetes Nutrition and Complications Trial: adherence to the ADA nutritional recommendations, targets of metabolic control, and onset of diabetes complications. A 7-year, prospective, population-based, observational multicenter study

J Diabetes Complications. Nov-Dec 2006;20(6):361-6. doi: 10.1016/j.jdiacomp.2005.09.003.


Objective: To know the adherence to the ADA nutritional recommendations and its relation to targets of metabolic control and onset of diabetic complications in a sample of diabetic people in Spain.

Research design and methods: The Diabetes Nutrition and Complications Trial (DNCT) is a prospective, population-based, observational multicenter study designed to know the nutritional pattern, based on the 7-day food diaries, of a population with long-standing diabetes mellitus (93/99 type 1/type 2 diabetic patients, 20/18 years of duration of diabetes, and 6.9%/6.4% HbA(1c) values) and its relation with the onset of microvascular and macrovascular diabetes complications between 1993 and 2000.

Results: After a median follow-up period of 6.5 years, more than 55% of diabetic people complied with the recommendation of protein intake between 15% and 20%, but only 27% consumed less than 10% of saturated fatty acids (SFAs), the 13% achieved up 10% of polyunsaturated fatty acids (PUFAs) intake, the 39% consumed more than 60% from carbohydrate and monounsaturated fatty acids (MUFAs), and the 30% consumed <300 mg/day of cholesterol. In spite of these, more than 90% had an optimal HDL cholesterol and non-HDL cholesterol level, and triglycerides level, while less than 41% of diabetic people had an HbA(1c) value >7.5%. Moreover, more than 69% consumed a MUFAs-to-SFAs ratio >1.5 and the 46% a PUFAs-to-SFAs ratio >0.4. Nonadherence to nutritional recommendation, but MUFAs/SFAs ratio >1.5 and PUFAs/SFAs ratio >0.4, was associated with a reduction between 3.4- and 8.2-fold in the risk of onset of diabetic complications.

Conclusions: The adherence to ADA nutritional recommendations for people with diabetes in Spain is rather poor except for the protein consumption. Only PUFAs/SFAs >0.4 and MUFAs/SFAs>1.5 were associated to near-optimal targets of metabolic control and a reduction in the risk of the onset of diabetic complications. These data suggest that other nutritional recommendations should be taken in mind.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / diet therapy*
  • Diet, Diabetic / standards*
  • Dietary Fats / administration & dosage
  • Dietary Fats / standards
  • Dietary Fats, Unsaturated / administration & dosage
  • Dietary Fats, Unsaturated / standards
  • Dietary Proteins / administration & dosage
  • Dietary Proteins / standards
  • Female
  • Humans
  • Male
  • Middle Aged
  • Population
  • Spain
  • United States


  • Dietary Fats
  • Dietary Fats, Unsaturated
  • Dietary Proteins