Abstract P630: Dietary Sodium Intake Increases the Risk of Developing Type 2 Diabetes Mellitus in the Million Veteran Program

Background: Type 2 Diabetes Mellitus (T2DM) affects 10.5% of the US population (~34.2 million people). While previous studies have shown that high intake of sodium is associated with the worsening of the T2DM parameters, it is unclear whether dietary sodium intake is associated with incidence of T2DM. We prospectively examined the association of sodium and potassium intake and risk for T2DM among participants of the Million Veteran Program (MVP). Methods: Between 2011 to 2020, 379,852 participants from the MVP completed a semi-quantitative food frequency questionnaire (sFFQ). Incidence of T2DM was ascertained using ICD-9 code 258.xx from electronic health records. We used Cox proportional hazards model to calculate hazard ratio (HR) with 95% confidence intervals (CIs) for T2DM adjusting for confounding factors. Results: Among the 234,721 veterans analyzed, mean age was 65 years (age range 19-106), 91% were male, and 88% were Caucasian. The observed energy-adjusted mean sodium intake was 1222 mg/day (1103 for females, 1234 for males) and potassium intake was 2596 mg/day (2534 for females, 2602 for males). During a mean follow-up of 4.4 years, 8,753 participants developed T2DM. After adjusting for confounding factors, a higher sodium intake was associated with 11% higher risk of T2DM (HR: 1.11, 95% CI: 1.04, 1.19, p-trend=0.0006); while a higher potassium intake was associated with a 6% lower risk of T2DM (HR: 0.94, 95% CI: 0.92, 0.97) (Figure). Conclusion: Higher intake of dietary sodium and lower intake of dietary potassium were each associated with a higher risk of developing T2DM among US veterans.