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Kidney Week

Abstract: PO1742

Association of Nutritional Data and Glycemic Variability in CKD Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Kapa, Nandakishor, University of California Davis Medical Center, Sacramento, California, United States
  • Badhesha, Harshanna, University of California Davis Medical Center, Sacramento, California, United States
  • Kim, Tae Youn, University of California Davis Medical Center, Sacramento, California, United States
  • Moss, Olivia A., University of California Davis Medical Center, Sacramento, California, United States
  • Vargas, Chenoa R., University of California Davis Medical Center, Sacramento, California, United States
  • Jin, Seung Mi, University of California Davis Medical Center, Sacramento, California, United States
  • Langer, Henning, University of California Davis Medical Center, Sacramento, California, United States
  • Rehman, Usman, University of California Davis Medical Center, Sacramento, California, United States
  • Norman, Jennifer E., University of California Davis Medical Center, Sacramento, California, United States
  • Ahmadi, Armin, University of California Davis Medical Center, Sacramento, California, United States
  • Jue, Thomas, University of California Davis Medical Center, Sacramento, California, United States
  • Afkarian, Maryam, University of California Davis Medical Center, Sacramento, California, United States
  • Roshanravan, Baback, University of California Davis Medical Center, Sacramento, California, United States
Background

Insulin resistance is highly prevalent in chronic kidney disease (CKD) and strongly associated with adverse clinical outcomes. Glycemic variability measured by continuous glucose monitoring (CGM) is a clinical measure of insulin resistance. The association of dietary recalls and healthy eating measures with CGM readings in CKD are unknown.

Methods

We recruited diabetic (n=7) and non-diabetic (n=8) participants with eGFR<60ml/min who had CGM performed over 2 weeks. The ASA24 Dietary Assessment Tool was used to perform dietary recalls on 3 random days over the CGM period. The Healthy Eating Index 2015 (HEI-2015) was used to determine how closely an individual's eating pattern matched Dietary Guidelines for Americans’ recommendations. A linear mixed model adjusting for diabetes status was used to determine association of dietary measures from ASA24, HEI-2015 scores, and CGM readings over 3 days.

Results

Participants had a mean age 59±11years, eGFR 35.5±4.6ml/min/1.73m2 and BMI 32.8±4.6kg/m2. Greater dietary added sugar, total carbohydrate, and carbohydrate to fiber ratio was associated with higher average daily blood sugar (P<0.001, P<0.001, and P=0.006, respectively). Each 1-point greater HEI score (healthier eating) was inversely associated with average daily blood sugar for fatty acid (-1.09 mg/dL; 95% CI -2.11, -0.07), added sugar (-1.76 mg/dL; CI -3.11, -0.4), vegetable (-2.85 mg/dL; CI -5.5, -0.2), and fruit (-2.63 mg/dL; CI -5.03, -0.22). HEI total score did not show significant association with the CGM readings.

Conclusion

Greater added sugar, saturated fats, and dietary carbohydrate to fiber ratio are strongly associated with greater average daily blood sugar. Sugar, carbohydrates, and saturated fats contribute to glycemic variability. Healthy eating centered on low sugar, low fat, and high vegetable and fruit intake may improve glycemic control in both diabetic and non-diabetic CKD patients.

HEI-2015 Scores Associated with CGM in Non-Diabetic and Diabetic CKD Patients
 CGM Value (β (95% CI))
HEI-2015 (n=15)Average daily blood sugar (mg/dL)Percent time above target (%)
HEI Fatty Acid-1.09 (-2.11, -0.07)-0.34 (-1.19, 0.5)
HEI Added Sugar-1.76 (-3.11, -0.4)-1.13 (-2.24, -0.02)
HEI Total Vegetable-2.85 (-5.5, -0.2)-1.18 (-3.36, 0.98)
HEI Total Fruit-2.63 (-5.03, -0.22)-1.39 (-3.37, 0.59)

Funding

  • NIDDK Support