Associations of dietary insulin load and dietary insulin index with diabetic nephropathy and reduced kidney function among women: a case-control study.

May 26, 2025

Experts: Faezeh Abaj,Atieh Mirzababaei,Mohammad Gholizadeh,Yasaman Aali,Paria Jadidi,Reza Amiri Khosroshahi,Cain C T Clark,Khadijeh Mirzaei

Increased insulin levels lead to hyperinsulinemia and insulin resistance (IR). IR is one of the main causes of the onset and progression of Diabetic Nephropathy (DN) and kidney failure in type 2 diabetic patients. The present case-control study sought to investigate the relationship between dietary insulin load (DIL) and index (DII) and the odds of DN and kidney function decline.
At the Kowsar Diabetes Clinic in Semnan, Iran, we enrolled 105 eligible women with DN and 105 controls (30-65 years old). Dietary insulin load (DIL) and index (DII) were assessed using a 147-item food frequency questionnaire (FFQ). Using standard protocols, biochemical variables and anthropometric measurements were evaluated for all patients. To investigate potential associations, binary logistic regression was used.
We found that higher DII was associated with 2.72 times higher odds of albuminuria (OR: 2.77; 95% CI 1.16, 6.63) and 1.92 times higher odds of DN (OR: 1.92; 95% CI 1.11, 3.32) compared to lower adherence. Additionally, DIL was found to be statistically highly connected with mild to severe reduction of glomerular filtration rate (GFR) in participants and 1.82 times greater odds of DN (OR = 1.82; 95% CI 1.01, 3.30).
The findings from this research showed that a higher odds of DN were related to a higher level of adherence to DIL and DII. Increased adherence to DIL was strongly correlated with the likelihood of a decreased GFR. To clarify our findings, more prospective research is necessary.

© 2025. The Author(s).

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ABOUT THE EXPERTS

Faezeh Abaj,Atieh Mirzababaei,Mohammad Gholizadeh,Yasaman Aali,Paria Jadidi,Reza Amiri Khosroshahi,Cain C T Clark,Khadijeh Mirzaei

Faezeh Abaj

Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.

Atieh Mirzababaei

Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. ati_babaee@yahoo.com.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. ati_babaee@yahoo.com.

Mohammad Gholizadeh

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.

Yasaman Aali

Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Paria Jadidi

Electronic Health and Statistics Surveillance Research Center, SR.C., Islamic Azad University, Tehran, Iran.

Reza Amiri Khosroshahi

Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Cain C T Clark

Institute for Health and Wellbeing, Coventry University, Coventry, CV1 5FB, UK.

Khadijeh Mirzaei

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. mirzaei_kh@tums.ac.ir.