• Yoshitaka Hashimoto, Ayumi Kaji, Ryosuke Sakai, Takafumi Osaka, Emi Ushigome, Masahide Hamaguchi, Masahiro Yamazaki, and Michiaki Fukui.
• Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: y-hashi@koto.kpu-m.ac.jp.
• Nutrition. 2020 Mar 1; 71: 110639.

ObjectivesThe association between skipping breakfast and glycemic parameters, including glycemic variability, in patients with type 2 diabetes is not well understood. Therefore, the aim of this study was to investigate the effects of skipping breakfast on glycemic parameters, including glycemic variability, in patients with type 2 diabetes.MethodsIn this cross-sectional study, we assessed lifestyle factors, including skipping breakfast, using a questionnaire method. We calculated the average, SD, and coefficient of variation (CV) of hemoglobin (Hb)A1c levels. The CV of HbA1c was defined as follows: CV = (SD / average HbA1c) × 100 (%).ResultsAmong 317 patients, 22 (6.9%) skipped breakfast. Patients who did not eat breakfast were younger (58 [14.5] versus 67.4 [10.1] y, P < 0.001) than those who did. The proportion of current smokers among patients skipping breakfast was higher than the proportion of smokers among patients who did not (40.9 versus 11.5%, P < 0.001). Average (7.7 [1.3] versus 7.1 [0.8]%, P = 0.003), SD (0.32 [0.17-0.85] versus 0.21 [0.14-0.35], P = 0.024) and CV (0.04 [0.03-0.10] versus 0.03 [0.02-0.05], P = 0.028) of HbA1c level were higher among patients who skipped breakfast than among those who did not. Multiple regression analysis revealed that skipping breakfast was associated with average HbA1c (β = 0.527, P = 0.006) and CV of HbA1c (β = 0.026, P = 0.001) after adjusting for age, sex, body mass index, duration of diabetes, exercise, smoking, amount of alcohol consumption, total energy intake, carbohydrate intake, and medications for diabetes.ConclusionsSkipping breakfast is independently associated with poor glycemic control, including glycemic variability, in patients with type 2 diabetes.Copyright © 2019 Elsevier Inc. All rights reserved.

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