Relationship between dietary intake in children with diabetes mellitus type I, their management at diagnosis, social factors, anthropometry and glycaemic control
AbstractBackground: In diabetes mellitus, dietary intake is important for metabolic control and contributes to the risk of developing microvascular and macrovascular complications. Little is known about factors influencing dietary intake. Objectives: To ascertain the long-term influence of two initial programmes of treatment of diabetes mellitus type I in children and adolescents on dietary intake and to compare with dietary recommendations. To examine for correlations with social factors, anthropometry and glycaemic control. Design: Children, 3-15 years of age, were chosen at random to be treated either in a paediatric ward (the control group) or, partly, in an apartment where their families were provided with extra psychological support and practical education (the study group). A prospective dietary assessment of 34 children with diabetes mellitus was performed, using 4 day food diaries at 6, 12 and 24 months after diagnosis. Results: Both management groups complied we ll with the dietary recommendations, showed stable nutritional habits during the first 2 years after diagnosis and had favourable intake concerning fat and carbohydrates compared with healthy children. The study group demonstrated less day-to-day variation in their consumption of polyunsaturated fat. Few dietary correlations to social factors were shown. There were no significant correlations between dietary intake and age or gender. High long-term HbA1c (8.3%, 5 years) was significantly associated with a higher intake of total fat, and more pronounced day-to-day variation in energy, carbohydrates and polyunsaturated fat. Conclusions: Both treatment programmes appear well suited for establishing and maintaining recommended dietary intake. The home-like environment of the training apartment made it possible to illustrate the dietary customs of the child and family, and permitted an individual nutritional education with behaviour modification. The importance of the quantity an d quality of fat consumed must be emphasized strongly. Keywords: children; diet; glycaemic control; insulin-dependent diabetes mellitus (type I); management regimen; social factors
Authors retain copyright of their work, with first publication rights granted to SNF Swedish Nutrition Foundation. Read the full Copyright- and Licensing Statement.