Evaluation of the Nutritional Status and Eating Behaviors of Young Children with Type 1 Diabetes and Healthy Peers: A Controlled Cross Sectional Study

Year 2024, Volume: 8 Issue: 1, 51 - 58, 29.04.2024

Seda Önal , Aslı Uçar , Zeynep Şıklar , Merih Berberoğlu

https://doi.org/10.25048/tudod.1455685

Abstract

Aim: Eating behaviors affect young children with type 1 diabetes mellitus (T1DM). The aim is to identify eating behaviors, and
nutritional status in young children with T1DM and healthy peers and evaluate the effect of eating behaviors on glycemic control in
children with T1DM.
Material and Methods: The study was a single-center controlled cross-sectional study of young children with T1DM (n=33) (age<7
years) and healthy peers (n=31).The eating behaviors of the young children were examined through the Behavioral Pediatric Feeding
Assessment Scale and the food consumption status was evaluated using a 3-day food record. Glycosilated hemoglobin (Hemoglobin
A1c) values of the young children with T1DM were obtained from hospital records, and analyzed.
Results: Young children with T1DM have higher energy, fiber, and cholesterol intake than their healthy peers. (p<0.05). The young
children with T1DM eat more healthily and have fewer behavioral eating disorders than their healthy peers. Parents of children with
T1DM reported feeling worse about the child’s nutrition. No relationship was found between eating behaviors and glycemic control.
Conclusion: Because parents of preschool children with type 1 diabetes feel more anxiety about their child’s disease, behavioral
observation techniques should be used to examine their eating behavior, glycemic control, and other factors that may affect nutritional
management.

Keywords

Nutrition, behavioral pediatric feeding assessment scale, young children, type-1 diabetes, eating behaviors

Ethical Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Rectorate of Ankara University with decision number 56786525-050.04.04/7012

Thanks

We would like to thank the parents who participated in this research, all the health workers who helped in the collection of the data.

Tip 1 Diyabetli Küçük Çocukların ve Sağlıklı Akranlarının Beslenme Durumları ve Yeme Davranışlarının Değerlendirilmesi: Kontrollü Kesitsel Araştırma

Abstract

Amaç: Yeme davranışları Tip 1 Diabetes Mellituslu (T1DM) çocukları etkilemektedir. Amaç T1DM'li küçük çocuklarda ve sağlıklı
akranlarında yeme davranışlarını ve beslenme durumunu belirlemek ve T1DM'li çocuklarda yeme davranışlarının glisemik kontrol
üzerindeki etkisini değerlendirmektir.
Gereç ve Yöntemler: Bu araştırma, T1DM'li küçük çocuklar (n=33) (yaş <7 yıl) ve sağlıklı akranları (n=31) üzerinde yapılan tek
merkezli, kontrollü, kesitsel bir çalışmaydı. Küçük çocukların yeme davranışları Davranışsal Pediatrik Beslenme Değerlendirme
Ölçeği ile incelendi ve 3-günlük besin tüketim kaydı kullanılarak besin tüketim durumları değerlendirildi. T1DM'li küçük çocukların
glikozillenmiş hemoglobin (Hemoglobin A1c) değerleri hastane kayıtlarından elde edildi ve analiz edildi.
Bulgular: T1DM’li küçük çocukların sağlıklı akranlarına göre enerji, posa ve kolesterol alımları daha yüksektir(p<0,05). T1DM’li küçük
çocuklar, sağlıklı akranlarına göre daha sağlıklı beslenmiş ve daha az davranışsal yeme bozukluğu yaşamışlardır. T1DM'li çocukların ebeveynleri, çocuklarının beslenmesi konusunda kendilerini daha kötü hissettiklerini bildirdi. Yeme davranışı ile glisemik kontrol
arasında bir ilişki bulunamadı.
Sonuç: T1DM’li okul öncesi çocukların ebeveynleri, çocuklarının hastalığıyla ilgili daha fazla kaygı duyduklarından, yeme davranışlarını,
glisemik kontrollerini ve beslenme yönetimini etkileyebilecek diğer faktörleri incelemek için davranışsal gözlem teknikleri kullanılmalıdır

Keywords

Beslenme, davranışsal pediatrik besleme değerlendirme ölçeği, küçük çocuklar, tip-1 diyabet, yeme davranışları

Ethical Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Rectorate of Ankara University with decision number 56786525-050.04.04/7012

Thanks

We would like to thank the parents who participated in this research, all the health workers who helped in the collection of the data.

References

• 1. Atkinson MA. The pathogenesis and natural history of type 1 diabetes. Cold Spring Harb Perspect Biol. 2012;4.
• 2. IDF Diabetes Atlas 2021 | IDF Diabetes Atlas. (Accessed Apr 23, 2023, at https://diabetesatlas.org/atlas/tenth-edition/)
• 3. Global report on diabetes (Accessed Apr 23, 2023, at https:// www.who.int/publications/i/item/9789241565257)
• 4. For Disease Control C. National Diabetes Statistics Report, 2017 Estimates of Diabetes and Its Burden in the United States Background. 2017
• 5. Jovanovic SM-, Jovanovic SM-. Nutritional Management in Type 1 Diabetes Mellitus. Type 1 Diabetes 2013 (Accessed Apr 23, 2023, at https://www.intechopen.com/chapters/41898)
• 6. Patton SR, Dolan LM, Chen M, Powers SW. Dietary adherence and mealtime behaviors in young children with type 1 diabetes on intensive insulin therapy. J Acad Nutr Diet. 2013;113(2):258-262.
• 7. Monaghan M, Herbert LJ, Wang J, Holmes C, Cogen FR, Streisand R. Mealtime behavior and diabetes-specific parent functioning in young children with type 1 diabetes. Health Psychol. 2015;34:794-801.
• 8. Powers SW, Patton SR, Byars KC, Mitchell MJ, Jelalian E, Mulvihill MM, Hovell MF, Stark LJ. Caloric intake and eating behavior in infants and toddlers with cystic fibrosis. Pediatrics. 2002;109(5):E75-75.
• 9. Patton SR, Williams LB, Dolan LM, Chen M, Powers SW. Feeding problems reported by parents of young children with type 1 diabetes on insulin pump therapy and their associations with children’s glycemic control. Pediatr Diabetes. 2009;10:455-460.
• 10. Mealtime interactions relate to dietary adherence and glycemic control in young children with type 1 diabetes. Diabetes Care. 2006;29(5):1002-1006.
• 11. Streisand R, Monaghan M. Young children with type 1 diabetes: Challenges, research, and future directions. Curr Diab Rep. 2014;14(9):520.
• 12. Crist W, Napier-Phillips A. Mealtime behaviors of young children: A comparison of normative and clinical data. J Dev Behav Pediatr. 2001;22:279-286.
• 13. Önal S, Çalık Var E, Uçar A. Davranışsal Pediatrik Besleme Değerlendirmesi Ölçeği (DPBDÖ)’ni Türkçe’ye Uyarlama Çalışması. Nevşehir Bilim ve Teknol Derg. 2017;6:93-101.
• 14. Castro K, Faccioli LS, Baronio D, Gottfried C, Perry IS, Riesgo R. Feeding behavior and dietary intake of male children and adolescents with autism spectrum disorder: A case-control study. Int J Dev Neurosci. 2016;53:68-74.
• 15. De Onis M, Lobstein T. Defining obesity risk status in the general childhood population: Which cut-offs should we use? Int J Pediatr Obes. 2010;5:458-460.
• 16. de Onis M, Onyango AW, Borghi E, Garza C, Yang H; WHO Multicentre Growth Reference Study Group. Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes. Public Health Nutr. 2006;9(7):942-947.
• 17. Barnard K, Thomas S, Royle P, Noyes K, Waugh N. Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. 2010;10:50.
• 18. Seckold R, Fisher E, de Bock M, King BR, Smart CE. The ups and downs of low-carbohydrate diets in the management of Type 1 diabetes: a review of clinical outcomes. Diabet Med. 2019;36:326-334.
• 19. Sundberg F, Barnard K, Cato A, de Beaufort C, DiMeglio LA, Dooley G, Hershey T, Hitchcock J, Jain V, Weissberg-Benchell J, Rami-Merhar B, Smart CE, Hanas R. ISPAD Guidelines. Managing diabetes in preschool children. Pediatr Diabetes. 2017;18(7):499-517.
• 20. 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;19 Suppl 27:136-154.
• 21. Mehta SN, Volkening LK, Quinn N, Laffel LMB. Intensively managed young children with type 1 diabetes consume highfat, low-fiber diets similar to age-matched controls. Nutr Res. 2014;34:428-35.
• 22. Overby NC, Flaaten V, Veierød MB, Bergstad I, Margeirsdottir HD, Dahl-Jørgensen K, Andersen LF. Children and adolescents with type 1 diabetes eat a more atherosclerosis-prone diet than healthy control subjects. Diabetologia. 2007;50(2):307-316.
• 23. Sasaki M, Kawasaki R, Rogers S, Man RE, Itakura K, Xie J, Flood V, Tsubota K, Lamoureux E, Wang JJ. The Associations of Dietary Intake of Polyunsaturated Fatty Acids With Diabetic Retinopathy in Well-Controlled Diabetes. Invest Ophthalmol Vis Sci. 2015;56(12):7473-7479.
• 24. Mackey ER, Rose M, Tully C, Monaghan M, Hamburger S, Herrera N, Streisand R. The current state of parent feeding behavior, child eating behavior, and nutrition intake in young children with type 1 diabetes. Pediatr Diabetes. 2020;21(5):841- 845.
• 25. Dovey TM, Jordan C, Aldridge VK, Martin CI. Screening for feeding disorders. Creating critical values using the behavioural pediatrics feeding assessment scale. Appetite. 2013;69:108-13.
• 26. American Diabetes Association. 13. Children and Adolescents: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S148-S164.