According to recent research, it has been found out that in patients with type 2 diabetes, lower 24-h urinary sodium excretion was paradoxically associated with increased all-cause and cardiovascular mortality, as published in the Diabetes Care Journal.
Many guidelines recommend that patients with type 2 diabetes should aim to reduce their intake of salt. However, the precise relationship between dietary salt intake and mortality in patients with type 2 diabetes has not been previously explored.
Hence, Elif I. Ekinci and colleagues from the Endocrine Centre, Austin Health and the University of Melbourne, Victoria, Australia carried out the present study to evaluate the association between dietary salt intake and mortality in patients with type 2 diabetes.
The authors assessed a total of six hundred and thirty-eight patients attending a single diabetes clinic. Baseline sodium excretion was estimated from 24-h urinary collections (24hUNa). The predictors of all-cause and cardiovascular mortality were determined by Cox regression and competing risk modeling, respectively.
The findings seen were-
a. The mean baseline 24hUNa was 184 ± 73 mmol/24 h, which remained consistent throughout the follow-up (intraindividual coefficient of variation [CV] 23 ± 11%).
b. Over a median of 9.9 years, there were 175 deaths, 75 (43%) of which were secondary to cardiovascular events.
c. All-cause mortality was inversely associated with 24hUNa, after adjusting for other baseline risk factors (P < 0.001).
d. For every 100 mmol rise in 24hUNa, all-cause mortality was 28% lower (95% CI 6–45%, P = 0.02).
e. After adjusting for the competing risk of non cardiovascular death and other predictors, 24hUNa was also significantly associated with cardiovascular mortality (sub-hazard ratio 0.65 [95% CI 0.44–0.95]; P = 0.03).
Therefore, the authors concluded that " In patients with type 2 diabetes, lower 24-h urinary sodium excretion was paradoxically associated with increased all-cause and cardiovascular mortality. Interventional studies are necessary to determine if dietary salt has a causative role in determining adverse outcomes in patients with type 2 diabetes and the appropriateness of guidelines advocating salt restriction in this setting."