Type 1 Diabetic Subjects with Diabetic Retinopathy Show an Unfavorable Pattern of Fat Intake

Nutrients. 2018 Aug 29;10(9):1184. doi: 10.3390/nu10091184.


Medical nutrition therapy is an important part of the management of type 1 diabetes mellitus (T1DM). Proper adherence to a healthy diet may have a favorable impact on diabetes management and its diabetic complications. Our aim was to assess differences in food and nutrient intake of type 1 diabetic patients with and without diabetic retinopathy (DR). This was a two-center, cross-sectional study in patients with T1DM, with and without DR. Subjects were recruited from the outpatient clinic of the two participating centers. A validated food frequency questionnaire was administered. A total of 103 T1DM patients with DR and 140 T1DM patient without DR were recruited. Subjects with DR showed a lower intake of total fat (p = 0.036) than that of their non-DR counterparts. DR was associated with increasing age (p = 0.004), hypertension (p < 0.001), and diabetes duration (p < 0.001), however there was a negative association with high educational level (p = 0.018). The multivariate-adjusted analysis showed that the intake of complex carbohydrates was positively related to the presence of DR (p = 0.031). In contrast, the intakes of total fat (p = 0.009), monounsaturated fatty acids (MUFAs) (p = 0.012), oleic acid (p = 0.012), and vitamin E (p = 0.006) were associated with the absence of DR. As conclusions, the intake of total MUFAs, oleic acid, and vitamin E is associated with a lower frequency of DR in patients with T1DM. These results suggest a potential protective effect of these lipid components for DR.

Keywords: carbohydrates; diabetic retinopathy; dietary pattern; fatty acids; oleic acid; type 1 diabetes.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / diet therapy
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / etiology*
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / prevention & control
  • Diet, Healthy
  • Diet, Mediterranean
  • Dietary Carbohydrates / adverse effects*
  • Dietary Fats / adverse effects*
  • Feeding Behavior*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status*
  • Patient Compliance
  • Protective Factors
  • Risk Factors
  • Spain


  • Dietary Carbohydrates
  • Dietary Fats