Effect of Dietary Inflammatory Index on Inflammatory Markers and Metabolic Parameters, in Patients With Type 2 Diabetes Mellitus
Condition: Type 2 Diabetes; Dietary Inflammatory Index (DII); Inflammation; Medical Nutrition Therapy
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2; Inflammation
Study type: Observational

Summary: 
      Nutrition is essential in the treatment and management of Type 2 Diabetes. The importance of
      adding foods with anti-inflammatory effects to daily diet plans in ensuring glycemic control,
      preventing the progression of diabetes, and reducing the risk of complications in the future
      is revealed by new studies added to the literature every day. This study aimed to determine
      the effects of the dietary inflammatory index (DII) on inflammation markers and metabolic
      parameters by determining the food consumption status of adults with type 2 diabetes who have
      good glycemic control.
    

Detailed description: 
      Nutrition is one of the most important determinants of inflammation. When the results of the
      studies were examined, it was seen that the diet was associated with inflammation in chronic
      diseases. It was observed that the consumption of foods such as simple carbohydrates, red
      meat, saturated fat, and trans fat was associated with high Interleukin-6 (IL-6) levels,
      which had a pro-inflammatory effect. It has been observed that the consumption of foods such
      as green leaves, vegetables, fruits, olive oil, whole grains, and fish in the Mediterranean
      type diet is associated with low levels of inflammation with anti-inflammatory effects. It is
      known that anti-inflammatory dietary components are essential in preventing chronic diseases.
      "Diet Inflammatory Index (DII)" was developed to determine the inflammatory load of diets.
      DII, nutritional components, pro-inflammatory markers C-reactive protein (CRP), Tumor
      Necrosis Factor Alpha (TNF-α), Interleukin 1 beta (IL-1β) and Interleukin 6 (IL-6) and
      anti-inflammatory markers Interleukin 10 (IL) -10) is an index provided by evaluating its
      effect on Interleukin 4 (IL-4). In order to obtain the inflammatory load of the diet, the
      impact of 45 nutritional parameters on inflammation is calculated. It is calculated as a
      positive score if the nutrient in the diet has a pro-inflammatory (increasing inflammation)
      effect and a negative score if it has an anti-inflammatory (reducing inflammation) effect.

      Studies conducted with diabetes and DII have observed that feeding individuals with a
      pro-inflammatory diet cause them to have higher DII scores, higher HbA1c, and an increased
      risk of developing diabetes.

      The primary purpose of this study is to find the relationship between the dietary
      inflammatory index and inflammatory markers in adult type 2 diabetes patients and to
      determine whether DII is a valid index in adult type 2 diabetes patients.

      The second aim is to evaluate the relationship between DII scores and metabolic parameters in
      adult type 2 diabetes patients.

      With the possible results, it aims to determine the measures to be taken to reduce the
      chronic inflammatory response due to nutritional status in type 2 diabetes patients and
      prevent the occurrence of diabetes-related complications.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        This study was selected among adult type 2 diabetes patients under control at Istanbul
        University Istanbul Medical Faculty Diabetes Polyclinic between November 2019 and April
        2020. The 120 patients included studying were between the ages of 30-74 and were sent to
        the diet polyclinic by their physicians. As the control group, 30 healthy people from the
        same age group were included. The data were collected by the researcher by face-to-face
        interview.
      
Keywords: Dietary inflammatory index (DII); Inflammation; Type 2 diabetes; inflammatory markers; biochemical parameters