We investigated the association between diet and risk of hospitalisation for diabetic ketoacidosis (DKA) or hypoglycaemia in type 1 diabetes. Food records were used to assess dietary intake. Data on DKA and hypoglycaemia hospitalisations, within two years of dietary assessments, were obtained from registries. Analyses were conducted with and without macronutrient substitution. Data were available from 1391 participants, 28 (2.0%) and 55 (4.0%) of whom were hospitalised due to DKA or hypoglycaemia, respectively. In the adjusted model, self-reported alcohol intake was associated with increased (per 10 g: B = 1.463, 95% CI = 1.114–1.922, p = 0.006; per E%: B = 1.113, 95% CI = 1.027–1.206, p = 0.009), and fibre intake with reduced (per g/MJ: B = 0.934, 95% CI = 0.878–0.995, p = 0.034) risk of DKA hospitalisation. Substituting carbohydrates for fats was associated with increased risk for hypoglycaemia hospitalisation (B = 1.361, 95% CI = 1.031–1.795, p = 0.029), while substituting alcohol for carbohydrates (B = 1.644, 95% CI = 1.006–2.685, p = 0.047) or proteins (B = 2.278, 95% CI = 1.038–4.999, p = 0.040) increased the risk for DKA hospitalisation. In conclusion, refraining from alcohol intake is a preventable risk factor for DKA, while higher fibre intake seems rather protective. Increasing carbohydrate intake while decreasing that of fats, is associated with higher hypoglycaemia risk. Whether this is a cause or effect of hypoglycaemia remains to be established.

我们调查了饮食与糖尿病酮症酸中毒 (DKA) 或 1 型糖尿病低血糖住院风险之间的关联。食物记录用于评估膳食摄入量。饮食评估两年内 DKA 和低血糖住院的数据是从登记处获得的。在有和没有宏量营养素替代的情况下进行分析。数据来自 1391 名参与者，其中分别有 28 名（2.0%）和 55 名（4.0%）因 DKA 或低血糖住院。在调整后的模型中，自我报告的酒精摄入量与增加有关（每 10 克：B = 1.463，95% CI = 1.114–1.922，p  = 0.006；每 E%：B = 1.113，95% CI = 1.027–1.206 , p  = 0.009)，纤维摄入量减少（每克/兆焦耳：B = 0.934，95% CI = 0.878–0.995，p = 0.034) DKA 住院风险。用碳水化合物代替脂肪与低血糖住院风险增加有关（B = 1.361，95% CI = 1.031–1.795，p  = 0.029），而用酒精代替碳水化合物（B = 1.644，95% CI = 1.006，p  = 2.68）0.047) 或蛋白质 (B = 2.278, 95% CI = 1.038–4.999, p  = 0.040) 增加了 DKA 住院的风险。总之，避免饮酒是 DKA 的可预防风险因素，而较高的纤维摄入量似乎具有保护作用。增加碳水化合物摄入量同时减少脂肪摄入量与较高的低血糖风险相关。这是否是低血糖的原因或影响仍有待确定。