The effect of family-based behavioral medical nutrition therapy education on nutritional status and metabolic control in children and adolescents with TYPE 1 diabetes

This study was conducted to examine the effect of family-based behavioral medical nutrition therapy training on nutritional status and metabolic control in children and adolescents with Type 1 diabetes. The research was carried out with children and adolescents aged 8-18 years who were followed up with the diagnosis of Type 1 Diabetes Mellitus in Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital. The sample of the study was consisted of 75 (male= 36, female= 39) children and adolescents in total, including Intervention 1 group (n=25), Intervention 2 (n=25) group and Control (n=25) group determined by double-blind, stratified, random method. Medical nutrition therapy and carbohydrate counting training were given to mothers and children in the Intervention 1 group, and only to children and adolescents in the Intervention 2 group. The control group did not receive medical nutrition therapy and carbohydrate counting training. At the beginning (0. month) and at the end (6. month) of the study, 3 consecutive day/24-hour food consumption records and anthropometric measurements of the individuals were assessed, BMI z-scores and height z-scores were calculated, Mediterranean Diet Quality Index Scale (KIDMED), Diabetes Eating Problems Survey–Revised (DEPS-R), Physical Activity Questionnaire for Children and Adolescents (PAQ-C and PAQ-A) were administered and Healthy Eating Index 2015 (HEI-2015) scores were calculated. Routinely assessed blood findings of the individuals were checked at the beginning (0. month), 3rd month and 6th month of the study. At the end of the study (6th month), energy and some macro (protein, fat, MUFA, fiber) and micronutrients (vitamins C, B1, B2, B6 and folate, zinc, iron, calcium, phosphorus, potassium, magnesium) intakes in the intervention groups were increased (p<0.05), no difference was observed in the control group (p>0.05). In the intervention groups, the HEI-2015 score and KIDMED scores were increased (p<0.05), while the DEPS-R score decreased in all 3 groups (P<0.05). The difference in the mean BMI and height z-score of the groups was not statistically significant (p>0.05). HbA1c (%) decreased in the intervention groups at the end of the training (6th month), and it was statistically significant only in the Intervention 1 group (p<0.05). In the control group, HbA1c (%) were increased at 6 months (p<0.05). A specialist pediatric dietitian experienced in childhood diabetes should be present as part of the interdisciplinary pediatric diabetes team, continuous monitoring, evaluation and education should be ensured. Key words: Type 1 diabetes, nutritional status, nutrition education, metabolic control