Dietary adherence and associated glycemic control in families of young children with type 1 diabetes

Objective This study examined the dietary intake, dietary adherence, and associated daily glycemic control of young children (mean age 5.6 [+ or -] 1.6 years) with type 1 diabetes in 33 families. Design This was a one-sample cross-sectional study. Children's nutrient and energy intakes were measured using 3-day diet diaries. Children's mean daily blood glucose levels were assessed prospectively for 2 weeks using the FreeStyle (TheraSense, Inc, Alameda, CA) home blood glucose meter. Statistical analysis Means, standard deviations, and frequencies described the sample. Associations between dietary adherence and glycemic control were examined by one-tailed Pearson correlations. Results Mean nutrient intakes were less than the Dietary Reference Intake for children's intake of vitamin B-12 and calcium. Children's dietary deviations revealed better-than-predicted adherence to the number and timing of feedings per day and number of carbohydrate units consumed per meal. In contrast, children's daily carbohydrate intake was approximately 80% [+ or -] 21% of the recommended levels based on their weight and age. In addition, children's energy intake was only 78% [+ or -] 18% of the recommended levels based on age. Correlations revealed a positive association between poor dietary adherence and higher blood glucose levels. Conclusions Young children with type 1 diabetes are likely to have adequate dietary intake of most micronutrients. However, their adherence to specific carbohydrate and energy intake recommendations may be lower. Because the preschool years represent a period of rapid growth, diet plans for preschoolers with diabetes need to be revised often for optimal management of type 1 diabetes. Close adherence to dietary recommendations is one behavior that may improve blood glucose control in young children with diabetes.