Abstract 17257: The Association Between Diet Quality After Diabetes Diagnosis and Major Cardiovascular Events in Women With Type 2 Diabetes Mellitus

Introduction: The role of dietary choices in the prevention of cardiovascular hard-outcome among type 2 diabetes patients has not been studied well. We examined whether there is an association between dietary quality after diagnosis of type 2 diabetes and major cardiovascular events among women using long-term prospective cohort study. Hypothesis: Healthy dietary pattern after type 2 diabetes diagnosis is associated with decreased risk for major cardiovascular events among women. Methods: The women with type 2 diabetes (n=6,895, mean age 64 years old) from the Nurses’ Health Study with no baseline cancer or cardiovascular disease were selected. Cox proportional hazard model was used to assess the multivariate association between the alternate Healthy Eating Index (aHEI) and the first episode of major cardiovascular events (coronary heart disease (CHD) or stroke). Results: During 26 years of follow-up (75, 276 person-years), a total of the 705 major cardiovascular events (432 cases of CHD, 314 cases of stroke, 41 cases of both CHD and stroke) were documented. The age-adjusted relative risks of major cardiovascular events across quintiles of aHEI score (Q1, Q2, Q3, Q4, Q5) were 1, 0.99 (95% CI, 0.80 to 1.22), 0.84 (CI, 0.67 to 1.05), 0.57 (CI, 0.44 to 0.72), and 0.66 (CI, 0.52 to 0.84) (P < 0.0001 for trend). These figures did not change materially after adjustment for body mass index, physical activity, smoking and other cardiovascular risk factors (1, 1.00, 0.91, 0.63, and 0.80, respectively; P = 0.008 for trend). The multivariate relative risks for stroke and CHD across quintiles of aHEI score were 1, 0.72, 0.80, 0.46, and 0.72 (P = 0.028 for trend) and 1, 1.21, 0.96, 0.72, and 0.73 (p=0.014 for trend), respectively. Conclusions: Healthier dietary habits after the diagnosis of diabetes are associated with a reduced risk of cardiovascular events including stroke and coronary heart disease.