Determination of the relationship between nutritional status with dietary fatty acids intake and adaptation to mediterranean diet scale in adults with type 2 diabetes

The types and levels of dietary fatty acids and blood fatty acids determine the serum lipid composition and affect the management of hyperglycemia in individuals with T2DM. Dietary fatty acids are not only an important source of energy, but also act as signal molecules in various cellular processes. In studies on diabetes and insulin resistance, there are data indicating that free fatty acid levels increase, and the relative amounts of saturated and unsaturated fatty acids also play an important role in the development of insulin resistance and diabetes. Various dietary models have proven useful for the prevention and management of T2DM; most of these dietary patterns are characterized by high consumption of plant-derived foods and low consumption of high-fat and processed foods of animal origin. The Mediterranean diet (MD) is a mainly plant-based diet pattern, and recent studies show that Mediterranean-style dietary habits have positive effects on cognitive functions and the course of chronic diseases such as diabetes mellitus and hypertension. This study was conducted to determine the effect of dietary fatty acid intakes and compliance with the Mediterranean diet on diabetic parameters in individuals with type 2 diabetes. The study was conducted on individuals aged 20-65 years, who came to the endocrinology outpatient clinic of Gaziantep University Şahinbey Research and Application Hospital between January and March 2020. The study included 48 individuals with type 2 diabetes, 32 (66.6%) female and 16 (33.3%) male, with an average age of 52.6 ± 9.0 years. A questionnaire form consisting of 38 multiple choice questions including general characteristics, health status and nutritional habits, and descriptive information about the status of physical activity was applied to the individuals diagnosed with Type 2 diabetes who agreed to participate in the study. A 3-day food consumption record was taken to determine the variety and amount of fatty acids that individuals receive with dietary energy, macro and micronutrients, and the Mediterranean Diet Commitment Scale (MEDAS), which consists of 14 questions, was used to determine patients' compliance with the mediterranean diet. According to BMI values of female individuals (34.4 ± 8.1 kg / m2), obese and male individuals (29.3 ± 8.8 kg / m2) were found to be overweight. Waist circumference measurements, which were measured as 109.6 ± 15.0 cm in female individuals and 105.4 ± 21.2 cm in male individuals, were found to be higher in women and men than the ideal range. A positive correlation was found between saturated fatty acid consumption and HbA1c levels of patients with type 2 diabetes (p = 0.03). Saturated fatty acids does not make a significant difference on HbA1c levels in the age and sex adjusted model (model 1), but a positive correlation was found between saturated fatty acid consumption and HbA1c levels in age and gender, the place where individuals live, their educational status, occupation, marital status, type 2 diabetes duration, other chronic diseases, family diabetes history, physical activity status and BMI values adjusted model (model 2), (p = 0.016). While no significant correlation was found between individuals' polyunsaturated fatty acid consumption amounts and HbA1c levels (p = 547), a negative relationship was found in model 2 obtained by adding other variables (p = 0.006). There was no statistically significant relationship between the compliance of individuals with the Mediterranean diet and fasting and postprandial blood glucose, c-peptide, HbA1c, BUN, creatinine, uric acid, ALT, AST, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride (p> 0.05). As a result, it has been determined that dietary fatty acid types may affect glycemic control parameters. While medical nutrition therapy is applied to individuals with type 2 diabetes, attention should be paid to the pattern of nutrients as well as the ideal consumption rates of macro and micronutrients.