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Dietary Sodium Tied to New-Onset Diabetes Risk

— Higher rates of type 2 and late autoimmune diabetes in adults with increasing sodium

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LISBON -- Those consuming high levels of sodium may be at greater risk for developing new-onset diabetes in adults, a new study found.

Among the Swedish population, risk for type 2 diabetes was associated with consuming a diet high in sodium (OR per gr/day; 1.43, 95% CI; 1.09-1.88), according to lead author Bahareh Rasouli, PhD, of the Institute of Environmental Medicine at the Karolinska Institute in Stockholm.

The findings were presented at the European Association for the Study of Diabetes meeting.

Also, development of LADA -- latent autoimmune diabetes in adults -- was tied to a high-sodium diet (OR 1.73 for each gram per day, 95% CI 1.23-2.43).

Risk was even greater among the highest tertile of daily sodium intake (≥2,870 mg/day) versus the lowest (≤2,354 mg/day), with an odds ratio of 2.19 (95% CI 1.33-3.61).

According to from the American Heart Association, individuals should not consume more than 2,400 mg of sodium per day (6 grams of salt).

High risk human leukocyte antigen (HLA) genotypes increased risk for LADA even further among patients on high-sodium diets, the researchers indicated (OR 3.87, 95% CI 1.87-8.01).

"In the European population, the prevalence [of LADA] is from 5% to 10% of all diabetes patients in adulthood. And some of the diabetes patients, at the beginning, they're misdiagnosed with type 2 diabetes patients," Rasouli explained to Ƶ, adding that testing of autoimmunity indicators is required to screen for the disorder. "And they need to be treated by insulin -- metformin is not enough for them."

Although the risk factors and underlying mechanisms linked to LADA risk are largely unknown, Rasouli suggested that sodium consumption in excess may prompt an autoimmune reaction due to an increased production of pro-inflammatory cells.

Her group drew on participant data from the Swedish-based ESTRID study of people with type 2 diabetes (n=1,136) and LADA (n=355), and a similar number of matched controls. Adjusted with the nutrition density method, sodium intake was calculated based off a self-reported food frequency survey.

Other significantly related characteristics of participants in the highest tertile of daily sodium intake -- above the recommended daily guidelines -- compared to the lowest included higher intake of processed meats, lower intake of fruits/vegetables, and higher likelihood of being physically inactive (P≤0.0019 for all comparisons).

Regarding future studies, Rasouli said her group plans to assess the genetic interaction with diet, particularly at the relationship with sodium, coffee, and other lifestyle-related dietary factors. She also stated plans to further analyze the interaction reported in the current study, specifically to look at the relationship between a high susceptibility to certain genes and high-risk lifestyle factors versus a lower-risk population.

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    Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

The study was funded by The Swedish Medical Research Council.

Rasouli reported no relevant disclosures.

Primary Source

European Society for the Study of Diabetes

Rasouli1 B, et al "Sodium intake and the risk of type 2 diabetes and Latent Autoimmune Diabetes in Adults (LADA)" EASD 2017; OP 38, Abstract 222.