183326 Are There Gaps in the Dietary Management of Adults with Coexisting Diabetes and Hypertension?

Wednesday, October 29, 2008: 8:45 AM

Gregory Legorreta , Columbia University, New York, NY
Lauren Simmons, MSW , Research and Development Service, VA New York Harbor Healthcare System, New York, NY
Jennifer P. Friedberg, PhD , Research & Development Service (151), VA New York Harbor Healthcare System/New York University School of Medicine, New York, NY
Donald Robinaugh, MA , Research & Development Service, VA New York Harbor Healthcare System, New York Campus, New York, NY
Judith Wylie-Rosett, EdD, RD , Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
Sundar Natarajan, MD, MSc , Research and Development Service, Department of Veterans Affairs New York Harbor Healthcare System & New York University, New York, NY
OBJECTIVES: Diabetes and hypertension frequently co-occur. Hypertension control is critical to prevent diabetes complications. Although certain dietary targets for both are similar (fiber, fat, protein) they also differ in important targets. We evaluated if these differences in recommendations are associated with suboptimal diet among diabetic and non-diabetic patients with hypertension in clinical practice.

METHODS: We analyzed data from hypertensive patients (n=178, 50% had diabetes) enrolled in a trial to improve hypertension treatment. Diet was assessed using Willett Food Frequency Questionnaires. Dietary differences between patients were tested using Wilcoxon rank-sum tests.

RESULTS: Diabetic patients scored lower than nondiabetic patients in the Healthy Eating Index (65.8 vs. 69.1, p<.05); other common-target comparisons were: fiber (16.2 g vs. 18.1 g, p=.15), total fat (33.3% vs. 32.1% of calories, p=.12), total protein (18.7% vs. 17.0 % of calories; p<.01). Hypertension-related diet comparisons between diabetic and nondiabetic patients (in mg) were: sodium (1816.9 vs. 1857.7, p=.59), potassium (2424.7 vs. 2757.7, p<.05), calcium (722.1 vs. 838.2, p <.05), magnesium (285.8 vs. 326.1, p<.05). The corresponding diabetes-specific diet comparisons were: diabetics ate fewer calories (1607.4 kcal vs. 1837.3 kcal, p=.01), and lower glycemic load (102.2 units vs. 120.3 units, p< .01).

IMPLICATIONS: Patients with diabetes and hypertension had lower HEI scores than those with hypertension alone, though their diet was better with respect to factors affecting glycemic control. Diabetic patients are not achieving all goals to control hypertension. Patients with coexisting hypertension and diabetes may require more help in creating and adhering to diets treating both diseases.

Learning Objectives:
1. Understand challenges of diet adherence in diabetes and hypertension 2. Appreciate current dietary management in clinical practice and recognize gaps in care that require improvement 3. Learn ways to address the suboptimal dietary management

Keywords: Chronic Illness, Dietary Assessment

Presenting author's disclosure statement:

Not Answered