Influence of dietary‐fibre intake on diabetes and diabetic retinopathy: Sankara Nethralaya‐Diabetic Retinopathy Epidemiology and Molecular Genetic Study (report 26)

BACKGROUND: The present study aims to report the influence of dietary-fibre intake on diabetes and diabetic microangiopathies among subjects >40 years in Urban India. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 1383 patients were included in the study, 1261 diabetics and 122 controls. METHODS: All subjects underwent comprehensive eye examination including assessment of diabetic retinopathy using fundus photography. Dietary-fibre intake was assessed using a validated questionnaire. All questions were validated based on factor analysis (overall communalities value >0.5). The cut-off for low-fibre diet was calculated by the average of study scores (≤ 32 for low-fibre diet). MAIN OUTCOME MEASURES: Prevalence of diabetes in subjects with low-fibre diet versus healthy diet and risk of microangiopathies. RESULTS: Subjects with low-fibre diet intake, had 1.51 times more risk of microalbuminuria than those with a healthy-fibre diet. Similarly, the odds of having diabetic retinopathy and sight-threatening diabetic retinopathy (odds ratio 1.41 [95% CI 1.02-1.94] and odds ratio 2.24 [95% CI 1.01-5.02], respectively) in low-fibre diet subjects were more. Low-fibre diet was consumed predominantly by lower socioeconomic status group (11.9 vs. 6.5, P=0.002). CONCLUSIONS: Subjects with type II diabetes had a lower dietary-fibre intake. The presence of diabetic retinopathy, sight-threatening diabetic retinopathy and microalbuminuria were also associated with lower dietary-fibre intake.