Influence of food consumption in the glycemic profile of children and adolescents with type 1 diabetes Mellitus
Palavras-chave:
Adolescent, Blood glucose self-monitoring, Child, Diabetes Mellitus, type 1, Food consumptionResumo
Objective
To review the dietary intake of children and adolescents with type 1 diabetes Mellitus and its association with the glycemic profile.
Methods
Longitudinal observational study. Dietary intake was measured using a three-day dietary record and the glycemic profile with a continuous glucose monitoring (range between 70 and 180mg/dL) and serum glycated hemoglobin levels (ideal <7.5%). Anthropometric data, insulin therapy, and carbohydrate counting were collected.
Results
The sample included 34 individuals with type 1 diabetes Mellitus aged 13.6±2.1 years. The majority of the population was eutrophic (76.4%). The entire sample used the basal-bolus insulin regimen, with mean insulin dose of 1.0±0.2U/kg/day; for 44.1% of the sample the carbohydrate counting method was used. Macronutrient sintake was adequate in only 8.8% of the individuals, the highest frequency of inadequacy was related to carbohydrates (p=0.07). Inadequate glycemic control with hyperglycemia episodes and high mean glycated hemoglobin (9.7%) was observed in all individuals (61.3±18.5%). Carbohydrate counting was responsible for maintaining the percentage of time that the patient had interstitial blood glucose values within the range >40% (p<0.001) and maintaining the percentage of time in hyperglycemia <50% (p<0.001).
Conclusion
The majority of individuals were eutrophic, but presented inadequate dietary intake and glycemic control. The method of counting carbohydrates positively influenced the glycemic profile.
Referências
Benkhadra K, Alahdab F, Tamhane S, Wang Z, Prokop LJ, Hirsch IB, et al. Real-time continuous glucose monitoring in type 1 diabetes: a systematic review and individual patient data meta-analysis. Clin Endocrinol. 2016;86:354-60.
International Diabetes Federation. International Diabetes Atlas. 8th. ed. Brussels: Federation; 2017 [cited 2018 Dec 10]. Available from: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/134-idfdiabetes-atlas-8th-edition.html.
Tschiedel B, Puñales M. Tratamento do diabetes: abordagens farmacológicas e cirúrgicas. In: Diabetes na prática clínica: edição 2.0. São Paulo: Sociedade Brasileira de Diabetes; 2015 [citado 10 dez 2018]. Disponível em: https://www.diabetes.org.br/publico/destaques/1008-e-book-2-0
Egídio J, Oliveira P, Junior R, Vencio S. Diretrizes da Sociedade Brasileira de Diabetes 2017-2018. São Paulo: Clannad; 2017 [citado 10 dez 2018]. Disponível em: https://www.diabetes.org.br/profissionais/images/2017/diretrizes/diretrizes-sbd-2017-2018.pdf
Vaz EC, Porfirio GJM, Nunes HRC, Nunes-Nogueira VDS. Effectiveness and safety of carbohydrate counting in the management of adult patients with type 1 diabetes mellitus: a systematic review and meta-analysis. Arch Endocrinol Metab. 2018;62(3):337-45.
Lottemberg AMP. Características da dieta nas diferentes fases da evolução do diabetes melito Tipo 1. Arq Bras Endrocrinol Metab. 2008;52:251-9.
Smart CE, Annan F, Higgins LA, Jelleryd E, Lopez M, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: nutritional management in children and adolescents with diabetes. Pediatr Diabetes. 2018;27:136-54.
Mańkiewicz-Żurawska I, Jarosz-Chobot P. Nutrition of children and adolescents with type 1 diabetes in the recommendations of the Mediterranean diet. Pediatr Endocrinol Diabetes Metab. 2019;25(2):74-80.
De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school: aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7.
Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, et al. International consensus on use of continuous glucose monitoring. Diabetes Care. 2017;40:1631-40.
Rewers MJ, Pillay K, Beaufort C, Craig ME, Hanas R, Acerini CL, et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes. ISPAD Clinical Practice Consensus Guidelines 2014 Compendium. Pediatr Diabetes. 2014;15(20):102-14.
Nutrilife Software. Nutrilife diet analysis: software of Nutrition. Version 9.0 [software]. Maringá: Nutrilife Software de Nutrição; 2016 [citado 15 out 2018]. Disponível em: http://www.nutrilifesoftware.com.br/netbook/setup.exe
German Institute of Human Nutrition Postdam-Rehbrucke. Multiple Source Method Progam. Version 1.0.1 [software]. 2008-2011 [cited 2018 Oct 30]. Available from:https://msm.dife.de
StatSoft. Statistica. Statistics progam. Version 10 [software]. 2010 [cited 2018 Nov 10]. Available from: www.statsoft.com
Nansel TR, Laffel LMB, Haynie DL, Mehta SN, Lipsky LM, Volkening LK, et al. Improving dietary quality in youth with type 1 diabetes: randomized clinical trial of a family-based behavioral intervention. Int J Behav Nutr Phys Act. 2015;12(58):1-11.
Seckold R, Howley P, King BR, Bell K, Smith A, Smart CE. Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets. Bmj Open Diabetes Res Care. 2019;7(1):1-7.
Pires M, Bani R, Lima G, Haddad MI, Takamoto P, Pires L, et al. Análise das dificuldades relacionadas ao seguimento de condutas terapêuticas do adolescente com diabetes mellitus tipo 1. J Human Growth Develop. 2016;26(1).
Katz ML, Mehta S, Nansel T, Quinn H, Lipsky LM, Laffel LM. Associations of nutrient intake with glycemic control in youth with type 1 diabetes: differences by insulin regimen. Diabetes Technol Ther. 2014;16(8):512-8.
Basu A, Alman AC, Snell-Bergeon JK. Dietary fiber intake and glycemic control: coronary artery calcification in type 1 diabetes (CACTI) study. Nutr J. 2019;18(23):2-8.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2017;40(1):4-5. 21. Ahola AJ, Forsblom C, Groop PH. Adherence to special diets and its association with meeting the nutrient recommendations in individuals with type 1 diabetes. Acta Diabetol. 2018;55(8):843-51.
Mosso C, Halabi V, Ortiz T, Hodgson MI. Dietary intake, body composition, and physical activity among toung patients with type 1. J Pediatr Endocr Met. 2015;28(7-8):895-902.
Teles SAS, Fornés NS. Consumo alimentar e controle metabólico em crianças e adolescentes portadores de diabetes melito tipo 1. Rev Paul Pediatr. 2011;29(3):378-84.
Silva ANS, Apolonio MS, Alcantara CM, Queiroz MVO. Características socioculturais e clínicas de adolescentes com diabetes mellitus tipo 1. Cogitare Enferm. 2016;21(4):1-8.
Junior RRL, Cardoso-Demartini AA, Ono AHA, Andrade, GC. Prevalência de obesidade em crianças e adolescentes com diabetes melito tipo 1. Rev Paul Pediatr. 2008;26(2):142-5.
Schwandt A, Hermann JM, Boettcher C, Dunstheimer D, Grulich-Henn J, Kuss O, et al. Longitudinal trajectories of metabolic control from childhood to young adulthood in type 1 diabetes from a large German/Austrian registry: a group-based modeling approach. Diabetes Care. 2017;40:309-16.
Campos, RA. Insulinoterapia. Nasce Crescer. 2011;20(3):182-4. 28. Maia, FFR, Araújo LR. A Hipoglicemia silenciosa é parte do controle glicêmico ideal em pacientes com DM1? tempo de hipoglicemia pelo CGMS versus média glicêmica. Arq Bras Endocrinol Metabol. 2008;52(6):994-1000.
Duarte SV, Rajão JS, Pinho JF, Santos LM, Alves-Neves CM, Magalhães GS, et al. Changes in aortic pulse componentes, pulse pressure amplification, and hemodynamic parameters of children and adolescentes with type 1 diabetes. Clin Care Technol. 2018;20(2):202-9.
Plamper M, Gohlke B, Wõfle J, Konrad K, Rohrer T, Hofer S, et al. Interaction of pubertal development and metabolic control in adolescents with type 1 diabetes mellitus. J Diabetes Res. 2017. https://doi.org/10. 1155/2017/8615769
Tascini G, Berioli MG, Cerquiglini L, Santi E, Mancini G, Rogari F, et al. Carbohydrate counting in children and adolescents with type 1 diabetes. Nutrients. 2018;20(1):109. https://doi.org/10.3390/nu10010109
Papakonstantinou E, Papavasiliou K, Maouri C, Magriplis E, Pappas S, Bousboulas S, et al. Postprandial glucose response after the consumption of three mixed meals based on the carbohydrate counting method in adults with type 1 diabetes: a randomized crossover trial. Clin Nutr. 2019;31:48-55. https://doi.org/10.1016/j.clnesp.2019.03.002
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Camilla Kapp FRITZ, Andreia Araújo Porchat de LEÃO, Márcia Regina Messaggi Gomes DIAS, Adriane de Andre Cardoso DEMARTINI, Suzana NESI-FRANÇA
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
