Background: Type 2 diabetes mellitus is one of the leading chronic diseases affecting Americans. There is a lack of literature discussing the link between diet and prognosis of those already diagnosed with DM. Objective: To provide insight into which diet is better for the outlook of diabetes mellitus by examining the associations between the low-carbohydrate diet (LCD) score and three diabetes-related health indicators: blood hemoglobin (HbA1c), triglycerides, and retinopathy. Methods: A total of 3,313 U.S. adults with DM were selected from the National Health and Nutrition Examination Survey 2005-2016. Presence of retinopathy was ascertained through self-reporting. Dietary intake was measured with 24- hour dietary recalls, and LCD scores were calculated from the proportion of energy of three macronutrients. Scores ranged from 0-30, with a higher score indicating lower carbohydrate intake. Results: There was no significant difference in HbA1c levels between the highest and the lowest quintile of LCD score (mean = 7.42% [95% CI: 7.23, 7.61] vs. 7.32% [95% CI: 7.13, 7.51]). There was no significant association between blood triglyceride levels and LCD score, comparing quintile 1 to quintile 5 (mean= 168.64 mg/dl; 95% CI = [150.14, 187.14] vs. mean= 162.44 mg/dl; 95% CI = [143.76, 181.11]). In multivariable logistic regression analysis, the odds ratio of having retinopathy comparing the highest to the lowest quintile was 1.01 (95% CI: 0.59, 1.72). Conclusion: Proportion of carbohydrate in diet was not associated with DM prognosis factors. Future studies should focus on carbohydrate quality as well as quantity.

Thesis Completion




Thesis Chair

Lee, Eunkyung


Bachelor of Science (B.S.)


College of Health Professions and Sciences


Health Sciences

Degree Program

Health Sciences Pre-Clinical



Access Status

Open Access

Length of Campus-only Access

1 year

Release Date