Differential associations of dietary patterns with estimated 10-year cardiovascular risk in diabetes subtypes

<jats:title>Abstract</jats:title> <jats:p> Diet impacts cardiovascular disease risk, but the association across diabetes subtypes is unclear. We thus aimed to assess the association between dietary factors and estimated 10-year cardiovascular disease risk across diabetes subtypes in the German Diabetes Study (GDS). Participants with recent-onset diabetes and from the 5-year follow-up examination were combined (n=635, mean age 47.5±12.9 years, 60% male) and classified into diabetes subtypes. Subtypes with prevalence &gt;10% were included in cross-sectional analyses: severe autoimmune diabetes (39%), mild obesity-related diabetes (31%), and mild age-related diabetes (30%). Carbohydrate quality parameters and adherence to dietary patterns were assessed from food frequency questionnaires. Differences in associations between these dietary factors and 10-year cardiovascular risk estimated by SCORE2-Diabetes across subtypes were examined using multivariable-adjusted linear regression models including an interaction term. In people with severe autoimmune diabetes, the overall and the healthful plant-based diet index were associated with lower estimated 10-year cardiovascular risk (ß [95% CI] -6.8 [-12.1; -1.2] and -8.8% [-14.0; -3.2] per 1-standard deviation increases, respectively), while these associations were not evident among the remaining two subtypes (p-value for interaction between subtypes &lt;0.05). Our findings suggest subtype-specific associations of plant-based dietary patterns with estimated cardiovascular risk, warranting further research from longitudinal and intervention studies. <jats:bold>Trial registration:</jats:bold> Clinicaltrials.gov: NCT01055093 </jats:p>