45 kg) and caloric requirements (20–30 kcal/kg/day) as per Misra et al.7 In the non-T2DM group (n=409), 66.8±9.1% (95% CI 65.9 to 67.7) of total energy came from total CHO. The difference between T2DM and non-T2DM groups was 2.7% (p<0.001). As expected, the non-T2DM group consumed simple CHO at Temsirolimus supplier a higher level than the recommended level (13.9±13.9%, 95% CI 11.1 to 15.3) and had a relatively lower consumption of complex CHO (52.9±13.3%, 95% CI 51.6 to 54.2). These findings were similar to those reported earlier by Radhika et al.11

The comparison of macronutrients (ie, region-wise CHO, fat and protein) revealed a similar pattern of dietary consumption, that is, high CHO and a lower range of fat and protein (figure 1). This study neutralises the myth that only the south Indian population consumes high CHO in their diet (rice, idli and so on). A similar dietary pattern was also reported in non-T2DM participants (figure 2). Our study shows that

only 38.1% of total T2DM participants (n=385, refer table 5) adhere to a diet. This finding is similar (37%, adherence to diet) to that in a study reported by Shobana et al12 earlier from south India. Moreover, adherence to the diet plan was higher (64.4%, n=218, refer table 5) in T2DM participants who were advised a diet plan by their physicians, but a little lower than that reported by Patel et al13 (73%) in a study from western India. These data further suggest the need for all people with T2DM to receive regular nutritional counselling from a dietitian/physicians.

We suggest that people with T2DM should be encouraged to achieve optimal metabolic control through a balance of food intake, physical activity and medication to avoid long-term complications. Most importantly, specific dietary recommendations should be individualised to accommodate the person’s preferences and lifestyle to enhance the acceptance and adherence to the diet plan. The cross-sectional study provides a good opportunity to assess glycaemic control in T2DM participants. In our study, 66.9% of T2DM participants had HbA1c above the targeted 7% (non-adjusted for co-variables). Patel et al13 reported similar findings in their study (35% had HbA1c <7%). In T2DM participants, higher blood glucose levels may reflect poor compliance to therapy, poor physical activity, poor awareness of cut-off points, importance of diet and so on. Engaging the physicians, trained dietician and people with diabetes for increasing awareness Carfilzomib of lifestyle changes to prevent long-term complications is clearly warranted. The amount of CHO consumed affects blood glucose levels and insulin responses.7 In our study, there was a trend (non-significant) towards higher consumption of CHO with high 2 h PPBG levels. Manobala et al14 reported that an increase in dietary CHO (% of energy), glycaemic load and weighted glycaemic index was associated with an increase in HbA1c levels.