Influence of dietary-fibre intake on diabetes and diabetic retinopathy: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetic Study (report 26)

Clin Exp Ophthalmol. 2012 Apr;40(3):288-94. doi: 10.1111/j.1442-9071.2011.02594.x. Epub 2011 Jul 26.


Background: The present study aims to report the influence of dietary-fibre intake on diabetes and diabetic microangiopathies among subjects >40 years in Urban India.

Design: Population-based cross-sectional study.

Participants: A total of 1383 patients were included in the study, 1261 diabetics and 122 controls.

Methods: All subjects underwent comprehensive eye examination including assessment of diabetic retinopathy using fundus photography. Dietary-fibre intake was assessed using a validated questionnaire. All questions were validated based on factor analysis (overall communalities value >0.5). The cut-off for low-fibre diet was calculated by the average of study scores (≤ 32 for low-fibre diet).

Main outcome measures: Prevalence of diabetes in subjects with low-fibre diet versus healthy diet and risk of microangiopathies.

Results: Subjects with low-fibre diet intake, had 1.51 times more risk of microalbuminuria than those with a healthy-fibre diet. Similarly, the odds of having diabetic retinopathy and sight-threatening diabetic retinopathy (odds ratio 1.41 [95% CI 1.02-1.94] and odds ratio 2.24 [95% CI 1.01-5.02], respectively) in low-fibre diet subjects were more. Low-fibre diet was consumed predominantly by lower socioeconomic status group (11.9 vs. 6.5, P=0.002).

Conclusions: Subjects with type II diabetes had a lower dietary-fibre intake. The presence of diabetic retinopathy, sight-threatening diabetic retinopathy and microalbuminuria were also associated with lower dietary-fibre intake.

MeSH terms

  • Albuminuria / epidemiology
  • Apolipoproteins E / genetics
  • Blood Glucose / metabolism
  • Body Constitution
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / genetics
  • Diabetic Retinopathy / diet therapy
  • Diabetic Retinopathy / epidemiology*
  • Diabetic Retinopathy / genetics
  • Dietary Fiber / administration & dosage*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • India / epidemiology
  • Lipoproteins, HDL / blood
  • Male
  • Middle Aged
  • Odds Ratio
  • Protein Kinase C / genetics
  • Receptors, Immunologic / genetics
  • Risk Factors
  • Social Class
  • Surveys and Questionnaires
  • Triglycerides / blood
  • Vascular Endothelial Growth Factor A / genetics


  • Apolipoproteins E
  • Blood Glucose
  • Dietary Fiber
  • Glycated Hemoglobin A
  • Lipoproteins, HDL
  • Receptors, Immunologic
  • Triglycerides
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Protein Kinase C