Population‐representative analysis of dietary supplementation among Americans with diabetes mellitus

Background Few population‐representative studies have examined dietary supplement use among Americans with diabetes mellitus (DM). This investigation analyzed dietary supplementation and DM data from the 2013–2014 National Health and Nutrition Examination Survey (NHANES). Methods Data from 5040 adult participants were analyzed, including 639 participants reporting a diagnosis of DM (Method 1), which increased to 1036 after including participants reporting “borderline” DM or prediabetes (Method 2). Participants reported dietary supplements used over the past month. The prevalence of supplementation was compared among participants with and without DM using the Rao–Scott likelihood Chi‐squared test; multivariate logistic regression was used to examine whether DM was an independent predictor of supplementation. Results Regardless of whether Method 1 or Method 2 was used, dietary supplementation was more prevalent among participants with DM (Method 1, 61.4% vs. 54.4%, P = 0.024; Method 2, 62.7% vs. 53.5%, P < 0.001). After adjusting for a variety of demographic and health‐related variables, the presence of DM was no longer associated with supplementation for Method 1 (odds ratio [OR] 1.01; 95% confidence interval [CI] 0.78–1.32; P = 0.925) or Method 2 (OR 1.13; 95% CI 0.91–1.41; P = 0.238). Approximately four of every five products taken for the purpose of managing DM were self‐prescribed, the most common being multivitamins–minerals, cinnamon‐containing supplements, and chromium‐containing supplements. Conclusions Slightly more than six out of 10 Americans with DM use dietary supplements each month and, although this is higher than Americans without DM, it does not appear to be due to DM per se. 摘要 背景 目前在有代表性的美国糖尿病(DM)人群中调查膳食补充剂使用情况的研究还很少。这项调查分析了来自2013‐2014年全国健康与营养调查研究(National Health and Nutrition Examination Survey,NHANES)的有关膳食补充剂与DM的数据。 方法 分析所用的数据来自于5040名成年参与者, 其中639名报告诊断为DM(方法1), 如果将报告诊断为“临界”DM或者糖尿病前期的参与者也计算在内, 那么这个数量将增加到1036名(方法2)。参与者报告了在过去的一个月中膳食补充剂的使用情况。在合并DM与不合并DM的参与者之间使用Rao‐Scott似然卡方检验比较了两组参与者的补充剂使用率;使用多元logistic回归分析来调查补充剂是否为DM的独立预测因子。 结果 无论是使用方法1还是方法2, 在合并DM的参与者中膳食补充剂的使用率都更高(方法1, 使用率分别为61.4%与54.4%,P = 0.024;方法2, 使用率分别为62.7%与53.5%,P < 0.001)。校正人口与健康相关变量后, 发现无论是使用方法1(优势比[OR]为1.01;95%置信区间[CI]为0.78‐1.32;P = 0.925)还是使用方法2(OR为1.13;95% CI为0.91‐1.41;P = 0.238), 存在DM都不再与补充剂相关了。在各种为了治疗DM而使用的补充剂中, 大约有五分之四都是自我处方的, 最常见的是含有多种维生素‐矿物质的补充剂、含肉桂的补充剂以及含铬的补充剂。 结论 在每10个合并DM的美国人中, 每个月都使用膳食补充剂治疗的人略多于6个, 与未合并DM的美国人相比虽然这个比例更高, 但是这与糖尿病本身似乎无关。 Highlights Data from