Effect of Nutritional Habits on the Glycemic Response to Different Carbohydrate Diet in Children with Type 1 Diabetes Mellitus

Nutrients. 2021 Oct 27;13(11):3815. doi: 10.3390/nu13113815.

Abstract

Unhealthy eating habits are associated with obesity, metabolic syndrome, and increased insulin resistance in young patients with type 1 diabetes mellitus (T1DM), and may impact the possible benefit from dietary interventions on glycaemic control. This study determines how nutritional patterns influence the quality of dietary intervention with a 30% or 50% carbohydrate diet in terms of glycaemic control measured with continuous glucose monitoring (CGM). Eating habits were obtained with a frequency-of-consumption questionnaire (FFQ-6) before the diet assessment. Altogether, we collected CGM and FFQ-6 data from 30 children (16 boys and 14 girls aged 10-17 years) with T1DM subjected to two consecutive 3-day nutritional plans. From these, 23 patients met the CGM data quality criteria for further analysis. Furthermore, high accuracy achieved in training (95.65%) and V-fold cross-validation (81.67%) suggest a significant impact of food habits in response to introduced nutritional changes. Patients who consumed more vegetables or grains (>4 times per day), more wheat products (>once per day), fewer fats (<1.5 times per day), and ranked fruit juice as the most common selection in the drinks category achieved glycaemic control more often after the introduction of a 30% carbohydrate diet, as opposed to those with different dietary patterns, whose glycaemic control was negatively impacted after switching to this diet. Additionally, the 50% carbohydrate diet was safe for all patients in the context of glycaemic control.

Keywords: carbohydrates; individualized nutritional guideline; paediatric diabetes.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring
  • Child
  • Cross-Over Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / diet therapy*
  • Diet Surveys
  • Diet, Carbohydrate-Restricted / methods*
  • Dietary Carbohydrates / administration & dosage*
  • Feeding Behavior / physiology
  • Female
  • Glycemic Control / statistics & numerical data*
  • Humans
  • Male

Substances

  • Blood Glucose
  • Dietary Carbohydrates