Impact of a Mediterranean diet, physical activity, body composition, and insulin delivery methods on metabolic control in children with type 1 diabetes

Yeray Nóvoa-Medina; Alicia Pérez-Lemes; Nerea Suárez-Ramírez; Marta Barreiro-Bautista; Himar Fabelo; Sara López-López; Sofia Quinteiro; Angela Domínguez; Marta León; María A González; Elisabeth Caballero; Ana M Wägner

doi:10.3389/fnut.2023.1338601

Impact of a Mediterranean diet, physical activity, body composition, and insulin delivery methods on metabolic control in children with type 1 diabetes

Front Nutr. 2024 Jan 5:10:1338601. doi: 10.3389/fnut.2023.1338601. eCollection 2023.

Authors

Affiliations

¹ Pediatric Endocrinology Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.
² Asociación Canaria para la Investigación Pediátrica (ACIP Canarias), Las Palmas de Gran Canaria, Canary Islands, Spain.
³ Instituto Universitario de Investigación Biomédica y Sanitaria (IUIBS), Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain.
⁴ Faculty of Medicine, Las Palmas de Gran Canaria University, Las Palmas de Gran Canaria, Canary Islands, Spain.
⁵ Complejo Hospitalario Universitario Insular-Materno Infantil, Fundación Canaria Instituto de Investigación Sanitaria de Canarias, Las Palmas de Gran Canaria, Spain.
⁶ Research Institute for Applied Microelectronics, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
⁷ Endocrinology and Metabolism Unit, Complejo Hospitalario Universitario Insular Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.

Abstract

Aims: To evaluate the synergistic impact of diet, lifestyle and technology on glycemic control in children with type 1 diabetes (T1D).

Methods: This cross-sectional study included 112 randomly selected patients with T1D from Gran Canaria (median age 12 years; 51.8% female). The study collected data on height, weight, body composition (bioimpedance), age, disease duration, and method of insulin delivery. Physical activity was evaluated using the Krece questionnaire and an accelerometer (GENEActiv). Adherence to the Mediterranean diet was assessed using the KIDMED Quick Nutrition Test. Glycemic control was evaluated using HbA1c and the percentage of time in range. SPSS version 21 and RStudio were used for statistical analysis of the data. Stepwise linear regression analysis (backwards) was used to identify factors independently associated with metabolic control.

Results: Insulin pump use, age and adherence to the Mediterranean diet were found to be significantly and independently associated with better glycemic control, whereas years with T1D was associated with worse HbA1c values. No relationship was found between body composition and physical activity measured by accelerometry or questionnaire.

Conclusion: Adherence to the Mediterranean diet, insulin delivery methods, age, and number of years with T1D are important factors to consider in the management of T1D in children.

Keywords: HbA1c; body composition; children; diet; nonpharmacological; physical activity; type 1 diabetes.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The use of accelerometers was possible thanks to funding from Instituto de Deportes del Cabildo de Gran Canaria (Project number OA22/044). This work was completed while HF was the beneficiary of the FJC2020-043474-I funded by MCIN/AEI/10.13039/501100011033 and by the European Union “NextGenerationEU/PRTR.” The funders had no role in the design, interpretation or writing of the results of the study.