Nutritional Factors and Preservation of C-Peptide in Youth With Recently Diagnosed Type 1 Diabetes

SEARCH Nutrition Ancillary Study

  1. Natalie The, PHD9
  1. 1Department of Nutrition and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  2. 2Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado
  3. 3School of Nursing and Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
  4. 4Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
  5. 5Cincinnati Children’s Hospital and Medical Center, Cincinnati, Ohio
  6. 6Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
  7. 7Department of Research and Evaluation, Kaiser Permanente, Southern California, Pasadena, California
  8. 8Department of Pediatric Endocrinology and Diabetes, Children’s Hospital and Regional Medical Center, Seattle, Washington
  9. 9Department of Health Sciences, Furman University, Greenville, South Carolina
  1. Corresponding author: Elizabeth J. Mayer-Davis, ejmayer-davis{at}unc.edu

Abstract

OBJECTIVE To test the novel hypothesis that nutritional factors previously associated with type 1 diabetes etiology or with insulin secretion are prospectively associated with fasting C-peptide (FCP) concentration among youth recently diagnosed with type 1 diabetes.

RESEARCH DESIGN AND METHODS Included were 1,316 youth with autoantibody-positive type 1 diabetes who participated in the SEARCH for Diabetes in Youth study (baseline disease duration, 9.9 months; SD, 6.3). Nutritional exposures included breastfeeding and age at introduction of complementary foods, baseline plasma long-chain omega-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin D, vitamin E, and, from a baseline food frequency questionnaire, estimated intake of the branched-chain amino acid leucine and total carbohydrate. Multiple linear regression models were conducted to relate each nutritional factor to baseline FCP adjusted for demographics, disease-related factors, and other confounders. Prospective analyses included the subset of participants with preserved β-cell function at baseline (baseline FCP ≥0.23 ng/mL) with additional adjustment for baseline FCP and time (mean follow-up, 24.3 months; SD, 8.2; n = 656). FCP concentration was analyzed as log(FCP).

RESULTS In adjusted prospective analyses, baseline EPA (P = 0.02), EPA plus DHA (P = 0.03), and leucine (P = 0.03) were each associated positively and significantly with FCP at follow-up. Vitamin D was unexpectedly inversely associated with FCP (P = 0.002).

CONCLUSIONS Increased intake of branched-chain amino acids and long-chain omega-3 fatty acids may support preservation of β-cell function. This represents a new direction for research to improve prognosis for type 1 diabetes.

Footnotes

  • Received October 11, 2012.
  • Accepted February 6, 2013.

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