Variation in nutrition education practices in SWEET pediatric diabetes centers - an international comparison
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Variation in nutrition education practices in SWEET pediatric diabetes centers - an international comparison. / Alonso, Guy Todd; Fink, Katharina; Maffeis, Claudio; Jannet, Svensson; Sari, Krepel-Volsky; Elizabeth, Davis; Przemysława, Jarosz-Chobot; Yash, Patel; Carmel, Smart.
I: Pediatric Diabetes, Bind 22, Nr. 2, 2021, s. 215-220.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Variation in nutrition education practices in SWEET pediatric diabetes centers - an international comparison
AU - Alonso, Guy Todd
AU - Fink, Katharina
AU - Maffeis, Claudio
AU - Jannet, Svensson
AU - Sari, Krepel-Volsky
AU - Elizabeth, Davis
AU - Przemysława, Jarosz-Chobot
AU - Yash, Patel
AU - Carmel, Smart
N1 - © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: Nutrition education is central to pediatric type 1 diabetes management. Dietary management guidelines for type 1 diabetes are evidence based, but implementation may be challenging and inconsistent. We describe variation in the practice of nutrition education across pediatric diabetes centers globally and explore associations with A1c and BMI.METHODS: In 2018, 77 pediatric diabetes clinics in the SWEET network received a survey about nutrition education. Using data submitted to the registry, regression analysis corrected for age, diabetes duration, BMI, and sex was used to compare survey parameters with A1c and BMI.RESULTS: Fifty-three centers who collectively cared for 22,085 patients aged 0 to 18 with type 1 diabetes responded. Median A1c was 7.68% [IQR 7.37-8.03], age 13.13 y [12.60-13.54], insulin pump use 39.1%, and continuous glucose monitor use 37.3%. 34% reported screening for disordered eating, but only 15.1% used validated screening tools. Recommending insulin boluses for snacks in patients taking insulin via injection varied, with 23% of the clinics giving this recommendation to half or fewer patients. In regression analysis, instructing patients to take insulin for snacks was the only survey parameter associated with the percent of clinic percent of patients attaining A1c <7.5% (<58 mmol/mol, P = 0.018) and < 7.0% (<53 mmol/mol, P = 0.026).CONCLUSIONS: There is considerable variation in nutrition education for pediatric patients with type 1 diabetes across this international registry. Consistently recommending independent of treatment modality (insulin pump or injections) that patients take insulin for snacks and more uniformity in screening for disordered eating are improvement opportunities.
AB - BACKGROUND: Nutrition education is central to pediatric type 1 diabetes management. Dietary management guidelines for type 1 diabetes are evidence based, but implementation may be challenging and inconsistent. We describe variation in the practice of nutrition education across pediatric diabetes centers globally and explore associations with A1c and BMI.METHODS: In 2018, 77 pediatric diabetes clinics in the SWEET network received a survey about nutrition education. Using data submitted to the registry, regression analysis corrected for age, diabetes duration, BMI, and sex was used to compare survey parameters with A1c and BMI.RESULTS: Fifty-three centers who collectively cared for 22,085 patients aged 0 to 18 with type 1 diabetes responded. Median A1c was 7.68% [IQR 7.37-8.03], age 13.13 y [12.60-13.54], insulin pump use 39.1%, and continuous glucose monitor use 37.3%. 34% reported screening for disordered eating, but only 15.1% used validated screening tools. Recommending insulin boluses for snacks in patients taking insulin via injection varied, with 23% of the clinics giving this recommendation to half or fewer patients. In regression analysis, instructing patients to take insulin for snacks was the only survey parameter associated with the percent of clinic percent of patients attaining A1c <7.5% (<58 mmol/mol, P = 0.018) and < 7.0% (<53 mmol/mol, P = 0.026).CONCLUSIONS: There is considerable variation in nutrition education for pediatric patients with type 1 diabetes across this international registry. Consistently recommending independent of treatment modality (insulin pump or injections) that patients take insulin for snacks and more uniformity in screening for disordered eating are improvement opportunities.
KW - Adolescent
KW - Child
KW - Child Nutritional Physiological Phenomena
KW - Diabetes Mellitus, Type 1/therapy
KW - Female
KW - Glycated Hemoglobin A
KW - Humans
KW - Male
KW - Patient Education as Topic
KW - Practice Patterns, Physicians'
KW - Registries
KW - Snacks
KW - Surveys and Questionnaires
U2 - 10.1111/pedi.13161
DO - 10.1111/pedi.13161
M3 - Journal article
C2 - 33220017
VL - 22
SP - 215
EP - 220
JO - Pediatric Diabetes
JF - Pediatric Diabetes
SN - 1399-543X
IS - 2
ER -
ID: 303040097