Objectives: The association between skipping breakfast and glycemic parameters, including glycemic variability, in patients with type 2 diabetes is not well understood. Therefore, the aim of this study was to investigate the effects of skipping breakfast on glycemic parameters, including glycemic variability, in patients with type 2 diabetes.
Methods: In this cross-sectional study, we assessed lifestyle factors, including skipping breakfast, using a questionnaire method. We calculated the average, SD, and coefficient of variation (CV) of hemoglobin (Hb)A1c levels. The CV of HbA1c was defined as follows: CV = (SD / average HbA1c) × 100 (%).
Results: Among 317 patients, 22 (6.9%) skipped breakfast. Patients who did not eat breakfast were younger (58 [14.5] versus 67.4 [10.1] y, P < 0.001) than those who did. The proportion of current smokers among patients skipping breakfast was higher than the proportion of smokers among patients who did not (40.9 versus 11.5%, P < 0.001). Average (7.7 [1.3] versus 7.1 [0.8]%, P = 0.003), SD (0.32 [0.17-0.85] versus 0.21 [0.14-0.35], P = 0.024) and CV (0.04 [0.03-0.10] versus 0.03 [0.02-0.05], P = 0.028) of HbA1c level were higher among patients who skipped breakfast than among those who did not. Multiple regression analysis revealed that skipping breakfast was associated with average HbA1c (β = 0.527, P = 0.006) and CV of HbA1c (β = 0.026, P = 0.001) after adjusting for age, sex, body mass index, duration of diabetes, exercise, smoking, amount of alcohol consumption, total energy intake, carbohydrate intake, and medications for diabetes.
Conclusions: Skipping breakfast is independently associated with poor glycemic control, including glycemic variability, in patients with type 2 diabetes.
Keywords: Breakfast; Diet; Diet habit; Glycemic control; Glycemic variability; Type 2 diabetes.
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