Training adolescents with type 1 diabetes to carbohydrate counting without parents’ help
Palabras clave:
Carbohydrate, Diabetes Mellitus type 1, Food and nutrition educationResumen
Objective
To develop and evaluate the effectiveness of a nutrition education program to enable adolescents with type 1 diabetes to count carbohydrates without the parents’ help.
Methods
Nineteen adolescents with type 1 diabetes from a diabetes center participated in four fortnightly meetings of one hour, with lectures and discussions about healthy nutrition, importance of nutrients for blood glucose, portion sizes, food replacements, and carbohydrate counting therapy. All meetings ended with exercises to check the learning. Adolescents were followed for one year after the intervention.
Results
All participants were 100% successful in all the steps of the program and started carbohydrate counting in the main meals. Nutritional status and total daily insulin doses before and after the study did not differ. After 12 months, 68% of the adolescents counted carbohydrates at all times, 16% did so in extra snacks, and 16% were suspended from the new therapy. Eighty percent of the parents were satisfied with the program, believing teenagers were trained in the new therapy.
Conclusion
A short nutrition education program successfully trained adolescents to count carbohydrates without the parents’ help.
Citas
American Diabetes Association. 2. Classification and diagnosis of diabetes. Diabetes Care. 2015; 38(Suppl.):S8-S16. http://dx.doi.org/10.2337/dc15-S 005
Dose Adjustment For Normal Eating. Study Group. Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: Dose Adjustment For Normal Eating (DAFNE) randomised controlled trial. BMJ. 2002; 325(7367):746.
Schlundt DG, Quesenberry L, Pichert JW, Wolf J, Ray S, Lorenz RA, et al. Evaluation of a training program for improving adherence-promotion skills of dietetic interns. J Am Diet Assoc. 1994; 94(12): 1421-5.
Mehta SN, Volkening LK, Anderson BJ, Nansel T, Weissberg-Benchell J, Wysocki T, et al. Dietary behaviors predict glycemic control in youth with type 1 diabetes. Diabetes Care. 2008; 31(7):1318-20. http://dx.doi.org/10.2337/dc07-2435
Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, et al. Nutrition recommendations and interventions for diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2008; 31(Suppl. 1):S61-78. http://dx.doi.org/ 10.2337/dc08-S061
Kawamura T. The importance of carbohydrate counting in the treatment of children with diabetes. Pediatr Diabetes. 2007; 8(Suppl. 6):57-62. http:// dx.doi.org/10.1111/j.1399-5448.2007.00287.x
American Diabetes Association. 4. Foundations of care: Education, nutrition, physical activity, smoking cessation, psychosocial care, and immunization. Diabetes Care. 2015; 38(Suppl.):S20-30. http://dx. doi.org/10.2337/dc15-S007
Mehta SN, Quinn N, Volkening LK, Laffel LM. Impact of carbohydrate counting on glycemic control in children with type 1 diabetes. Diabetes Care. 2009; 32(6):1014-6. http://dx.doi.org/10.2337/dc08-2068
Brazeau AS, Mircescu H, Desjardins K, Leroux C, Strychar I, Ekoe JM, et al. Carbohydrate counting accuracy and blood glucose variability in adults with type 1 diabetes. Diabetes Res Clin Pract. 2013; 99(1):19-23. http://dx.doi.org/10.1016/j.diabres. 2012.10.024
Smart CE, Ross K, Edge JA, King BR, McElduff P, Collins CE. Can children with Type 1 diabetes and their caregivers estimate the carbohydrate content of meals and snacks? Diabet Med. 2010; 27(3): 348-53. http://dx.doi.org/10.1111/j.1464-5491.20 10.02945.x
Waldron S, Hanas R, Palmvig B. How do we educate young people to balance carbohydrate intake with adjustments of insulin? Horm Res. 2002; 57(Suppl. 1): 62-5.
Spiegel G, Bortsov A, Bishop FK, Owen D, Klingensmith GJ, Mayer-Davis EJ, et al. Randomized nutrition education intervention to improve carbohydrate counting in adolescents with type 1 diabetes study: Is more intensive education needed? J Acad Nutr Diet. 2012; 112(11):1736-46. http:// dx.doi.org/10.1016/j.jand.2012.06.001
Chaney D, Coates V, Shevlin M, Carson D, McDougall A, Long A. Diabetes education: What do adolescents want? J Clin Nurs. 2012; 21(1-2): 216-23. http://dx.doi.org/10.1111/j.1365-2702. 2010.03692.x
Wylie-Rosett J, Aebersold K, Conlon B, Ostrovsky NW. Medical nutrition therapy for youth with type 1 diabetes Mellitus: More than carbohydrate counting. J Acad Nutr Diet. 2012; 112(11):1724-7. http://dx.doi.org/10.1016/j.jand.2012.07.033
American Diabetes Association. Standards of medical care in diabetes-2015: Summary of revisions. Diabetes Care. 2015; 38(Suppl.):S4. http:// dx.doi.org/10.2337/dc15-S003
Rosenbloom AL, Silverstein JH, Amemiya S, Zeitler P, Klingensmith GJ. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Type 2 diabetes Mellitus in the child and adolescent. Pediatr Diabetes. 2008; 9(5):512-26. http://dx.doi.org/ 10.1111/j.1399-5448.2008.00429.x
Health Canada. Dietary Reference Intakes. Otawa: Health Canada; 2005 [cited 2013 Aug 13]. Available from: http://www.hc-sc.gc.ca/fn-an/nutrition/ reference/table/index-eng.php
Brown SA. Interventions to promote diabetes self management: State of the science. Diabetes Educ. 1999; 25(6 Suppl.):52-61.
Sociedade Brasileira de Diabetes. Departamento de Nutrição. Manual oficial de contagem de carboidra tos regional. Rio de Janeiro: Sociedade Brasileira de Diabetes; 2009.
Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, et al. National standards for diabetes self-management education and support. Diabetes Care. 2014; 37(Suppl. 1):S144-53. http://dx.doi.org/ 10.23 37/dc14-S144
Vygotsky L. Pensamento e linguagem. São Paulo: Martins Fontes; 1987.
Piaget J. A epistemologia genética/sabedoria e ilusões da filosofia: problemas de psicologia gené tica. São Paulo: Abril Cultural; 1983.
Lange K, Swift P, Pankowska E, Danne T. Diabetes education in children and adolescents. Pediatr Diabetes. 2014; 15(Suppl. 20):77-85. http://dx.doi. org/10.1111/pedi.12187
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Derechos de autor 2023 Beatriz Diniz GABRIEL, Cristiano Tulio ALBUQUERQUE, Marcella Lobato Dias CONSOLI, Patrícia Amaral Fulgêncio da Cunha MENEZES, Janice Sepúlveda REIS
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
