The influence of dietary intake and meal pattern on blood glucose control in children and adolescents using intensive insulin treatment

Abstract

Aims/hypothesis We studied dietary factors and their association with blood glucose control in type 1 diabetic children and adolescents using intensive insulin treatment. Materials and methods A total of 550 children and adolescents with type 1 diabetes mellitus (age 2-19 years) recorded their diet for 4 days in pre-coded food diaries. Of the study group, 34% used insulin pumps, 43% used four or more injections and 16% three injections per day. HbA 1c was related to targets of optimal blood glucose control defined by the International Society for Pediatric and Adolescent Diabetes (ISPAD). Results Adolescents with optimal glucose control (HbA 1c ≤7.5%) had a lower intake of added sugar (7.7 vs 9.1% of energy intake, p=0.004), a higher intake of fibre (19.3 vs 17.0 g/day, p=0.01) and a higher intake of fruits and vegetables (257 vs 227 g/day, p=0.04) than those with suboptimal metabolic control (HbA 1c >7.5%). Multiple regression analysis in adolescents showed that fibre and meal pattern were significantly associated with blood glucose control (effect fibre intake=−0.02, p=0.04, effect having breakfast regularly=−0.89, p=0.009). In children meal pattern was associated with blood glucose control (effect having dinner regularly=−0.66, p=0.02, effect having supper regularly=−0.78, p=0.03). Conclusions/interpretation In diabetic adolescents both intake of fibre and having a regular meal pattern are associated with blood glucose control. Lower intake of added sugar and sugar-sweetened soft drinks and higher intake of fruits and vegetables are observed among those with optimal compared with those with suboptimal blood glucose control. Dietary guidance should be intensified during adolescence to improve dietary intake and blood glucose control.

Dietary intake, body composition, and physical activity among young patients with type 1 diabetes mellitus

“…Our result was also concordant with the study by Maffeis et al (17) of Italian children, but lower than for other studies (5,18,19) . Dietary fat was correlated with HbA 1c , which was similar to the results found in Australian (20) , Norwegian (21) , and Italian (17) children. Fat intake is a predictor of fat gain and changes in the percentage of body fat in adolescents with T1DM (17,18) .…”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…[321][322][323][324][325][326] Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, which prescribes a high proportion of fruits and vegetables, was associated with lower BP, better ratio of LDL to HDL, and lower HbA 1c in youth with T1DM. 327,328 Sugar-sweetened beverage consumption and diet beverage consumption have been associated with adverse lipid, BP, and HbA 1c levels, which may be a marker for other concurrent unhealthy lifestyle behaviors (eg, unhealthy diet, sedentary lifestyle, and increased screen time).…”

Dietary Behaviors Predict Glycemic Control in Youth With Type 1 Diabetes

“…In addition, these youth also monitored blood glucose more frequently. This may relate to the focus on nutrition and BGM during the pump implementation process or the selection of patients for pump therapy who demonstrate adequate adherence (8,9). Alternatively, youth using pumps may be more attentive to dietary and BGM behaviors because they need to administer insulin throughout the day.…”