Association Between Dietary Salt and Plasma Glucose, Insulin and Hemoglobin A1c Levels Among Type 2 Diabetes Patients in Eastern China

Yi Lin; Kaushik Chattopadhyay; Xi Yang; Jia-Lin Li; Yan-Shu Chen; Ye Zhou; Li Li

doi:10.2147/DMSO.S338915

Association Between Dietary Salt and Plasma Glucose, Insulin and Hemoglobin A_1c Levels Among Type 2 Diabetes Patients in Eastern China

Diabetes Metab Syndr Obes. 2021 Dec 19:14:4811-4818. doi: 10.2147/DMSO.S338915. eCollection 2021.

Authors

Yi Lin¹, Kaushik Chattopadhyay², Xi Yang³, Jia-Lin Li⁴, Yan-Shu Chen⁴, Ye Zhou⁴, Li Li⁴

Affiliations

¹ Center for Health Economics, Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, Zhejiang Province, People's Republic of China.
² Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
³ Department of Nutrition, Ningbo First Hospital, Ningbo, Zhejiang Province, People's Republic of China.
⁴ Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, Zhejiang Province, People's Republic of China.

Abstract

Purpose: Type 2 diabetes (T2D) is one of the major public health concerns in China. Studies on the association between dietary salt intake and the glycemic response of T2D are lacking in China. The aim was to investigate the association between the levels of dietary salt intake and the plasma glucose, insulin and hemoglobin A_1c (HbA₁ _c) levels in T2D patients.

Methods: Patients with T2D, who accepted management and treatment by the National Standardized Metabolic Disease Management Center at Ningbo First Hospital from March 2018 to January 2020, were included in this study. Dietary salt intake was assessed through a standardized food frequency questionnaire. Anthropometry, blood pressure and biomarkers were measured by well-trained endocrinology nurses. Generalized linear models (GLMs) were used to examine the associations.

Results: A total of 1145 eligible T2D patients with a mean age of 51.4 years were included in the study. Fasting plasma glucose (FPG), 2-hour postprandial plasma glucose and 2-hour postprandial insulin were significantly increased across dietary salt categories. The GLMs further showed that dietary salt intake >8 g/day was positively associated with FPG and HbA_1c.

Conclusion: Higher daily salt intake was found to be associated with FPG and HbA_1c in T2D patients. Lifestyle education and promotion of salt reduction should be provided to T2D patients.

Keywords: China; blood glucose; dietary salt; glycated hemoglobin A1c; insulin; type 2 diabetes.

Grants and funding

This study was supported by the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (grant no. 2019331427), Major Program of Social Development of Ningbo Science and Technology Bureau (grant no. 2019C50094) and Ningbo Science and Technology Bureau (grant no. 2019A610391).