Introduction and Objective: Hyperinsulinemia is closely linked to insulin resistance (IR) and mostly considered as compensatory, yet evidence suggests primary hypersecretion can even precede and promote IR. We asked the question if specific dietary patterns are associated with whole-body IR-independent increases in fasting C-peptide, defined as discordant hyperinsulinemia (DH). Methods: In the German Diabetes Study (GDS), 266 participants with recent-onset type 2 diabetes (T2D) who filled in food-frequency questionnaires were analyzed. Whole-body insulin sensitivity (IS) was measured using euglycemic-hyperinsulinemic clamp. DH was assessed as residuals of fasting C-peptide, regressed on IS. Partial least squares (PLS) regression was used to derive a dietary pattern associated with DH. Associations were evaluated in linear regression models adjusted for age, sex, socioeconomic status, physical activity, smoking status, alcohol intake and BMI. Effect estimates represent SD-changes in DH per 1-SD higher dietary pattern score. Results: Across the study population mean IS was 6.0 mg*kg-¹*min-¹ (SD 2.5 mg*kg-¹*min-¹) and mean C-peptide was 3.3 ng/ml (SD 1.5 ng/ml). PLS identified a dietary pattern characterized by higher intake of processed meat, sweets, potatoes and lower intake of vegetables, legumes, nuts/seeds, cereals, tea and plant fat. The dietary pattern score was positively associated with DH in models without (β=0.24, 95% CI 0.10; 0.38; p0.001) and with additional adjustment for BMI (β=0.19, 95% CI 0.06; 0.32; p0.05). Conclusion: A diet high in processed meat, potatoes and sweets and low in plant-based, fiber-rich food groups was associated with higher DH in recent onset T2D. These findings suggest that diet may contribute to differences in fasting C-Peptide independent of whole-body IR in early T2D. Disclosure J. Schweinitzer: None. K.B. Bódis: Other - travel support; Ended; Sanofi. Other - lecture honoraria; Ended; Pfizer Inc. V. Burkart: None. C. Herder: None. A. Lang: None. T. Koessler: None. J. Barbaresko: None. I. Yurchenko: None. D.M. Mendez Cardenas: None. M. Roden: Advisory Panel; Current; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly, Madrigal Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Echosens. S. Schlesinger: Other - Speaker honorarium; Ended; Novo Nordisk. R. Wagner: Advisory Panel; Current; Sanofi. Speaker's Bureau; Ended; Daiichi Sankyo, Novo Nordisk.
SCHWEINITZER et al. (Fri,) studied this question.