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/Advisor

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