Exploring the effect of adhering to a healthy lifestyle pattern on glycemic control in adults with type 1 diabetes mellitus.

Abstract

Background and aims: Diet, physical activity, sleep and smoking have been individually associated with glycemic control (GC) in adults with type 1 diabetes mellitus (T1D). However, the combined effect of these factors has not been investigated. The aim of the present study was to examine the single and combined effects of lifestyle parameters on GC of people with T1D (PwT1D).

Methods and results: Dietary, physical activity and sleep habits were evaluated using validated questionnaires. Diet quality was assessed with two scores (MedDietScore and PURE Diet Score) and two healthy lifestyle indices (HLI) were constructed (MLI based on MedDietScore and PLI based on PURE score). The score of both HLI ranged from 0 to 12 with higher scores indicating greater adherence to the healthy lifestyle pattern. One hundred ninety-two adults [61 % female, median age 42 (34, 51) years] with T1D were included in the analysis. Good GC (defined as HbA1c<7 %) was observed in 31 % of study participants. Examining lifestyle components separately, only smoking was marginally inversely associated with good GC [odds ratio (OR): 0.48, (95 % confidence interval, CI:0.23-1.00; p = 0.050)]. Individuals with better GC had significantly higher HLI scores (both p < 0.05). After adjusting for age, sex, body mass index, wearing an insulin pump and using continuous glucose monitoring, one-unit increase in the PLI was associated with 16 % higher likelihood of good GC (OR:1.16, 95 % CI:1.01-1.35, p = 0.04) and a similar trend was recorded for MLI (p = 0.05).

Conclusion: Our results suggest that adherence to a healthy lifestyle, more so than single lifestyle parameters, is associated with better GC in PwT1D.