Background: Reports continue to show that lifestyle modiï¬cation is cornerstone in the management of type 2 diabetes mellitus (T2DM). However, lifestyle and cultural patterns vary significantly across communities thereby necessitating the need for tailored dietary interventions to achieve optimal glycemic control. Presently, few prospective studies in Nigeria demonstrate the potential effects of diet modification on cardiometabolic, inflammation and prothrombotic factors. This study therefore assessed the effects of a twelve-month dietary modification on cardiometabolic, inflammation and prothrombotic factors in individuals with T2DM.
Materials and Methods: Forty adults with T2DM were enrolled into this study. They were placed on 20%, 30% and 50% total caloric intake obtained from protein, fat, and carbohydrate respectively and were followed up for 12 months. Adherence to the dietary modification was assessed using a surrogate index. Standard methods were used to measure the blood pressure and anthropometric indices. Lipid profile, fasting plasma glucose (FPG), fibrinogen, plasminogen activator inhibitor-1 (PAI-1)], interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured using spectrophotometric methods and ELISA as appropriate. Data analysis was done using paired Studentâ€™s t-test, Wilcoxon signed-rank test and Spearman correlation as appropriate. P-value less than0.05 was considered as statistically significant.
Results: There were no significant changes in the mean body weight, body mass index (BMI), hip circumference (HC), waist-hip ratio, systolic (SBP) and diastolic (DBP) blood pressure, FPG and low density lipoprotein-cholesterol (LDL-C) at 6 months and 12 months compared with the baseline. However, the mean levels of high density lipoprotein-cholesterol (HDLc) was significantly elevated while the mean waist circumference (WC) and waist-to-height ratio (WHtR) were significantly reduced at 12-month compared with baseline. Interleukin-10 (IL-10) level was significantly higher at 6months compared with the baseline but reduced significantly at 12-month compared with the 6-month level. Unexpectedly, there was significant progressive rise in the median level of fibrinogen at 6-month and 12-month compared with the baseline. Similarly, plasminogen activator inhibitor-1 (PAI-1) levels at 6-month and 12-month were significantly higher compared with the baseline.Conclusion: It could be concluded from this study that twelve months of dietary modification improved central adiposity and high density lipoprotein-cholesterol but could not halt prothrombosis.